Scottish Parliament, 28 April 2005

419 contributions from 75 members. The official report.

Official Report 28 April 2005

Smoking, Health and Social Care (Scotland) Bill: Stage 1

George Reid (None, Ochil)

Good morning. The first item of business is a debate on motion S2M-2667, in the name of Andy Kerr, that the general principles of the Smoking, Health and Social Care (Scotland) Bill be agreed to.

Andy Kerr (Labour, East Kilbride)

Lives have been destroyed, families have been devastated and careers have been shattered—those are the tragic consequences of illness and disease caused by tobacco smoke. In response to its consultation on a prohibition on smoking, the Scottish Executive received letters from many, many people whose lives have been blighted by the consequences of exposure to second-hand tobacco smoke. They include wives whose non-smoking husbands have died of lung cancer, asthmatics who cannot socialise in pubs and mothers who are concerned for their sons who work in bars. Those are examples of just some of the real-life stories that people have to tell about the devastating effect that tobacco smoke can have on people's lives.

Each year environmental tobacco smoke in Scotland is associated with the deaths of more than 800 people who have never smoked. That is why we must take this historic, bold and right step to improve the health of the people of Scotland. The Executive and I are proud that we in Scotland are leading the rest of the United Kingdom in the smoking debate, which is a tribute to devolution.

I thank the Health Committee for its careful and considered conclusions in its stage 1 report and I am pleased to note that it is broadly supportive of the measures that we propose. I thank the many witnesses who provided evidence to the Health Committee and I thank the Finance Committee and Subordinate Legislation Committee for their considerations.

The bill has three main purposes. The first is to introduce a prohibition on smoking in certain enclosed public spaces. The second is to continue the modernisation of the national health service, including removing charges for eye and dental checks; improving the provision of dental and pharmaceutical care; improving NHS disciplinary processes; and allowing the NHS to participate in joint ventures for the delivery of facilities and services. Thirdly, the bill seeks to make social care provisions in relation to the Regulation of Care (Scotland) Act 2001. Clearly, this is a health bill and it is within the competence of the Parliament.

I turn to the specifics of the smoking provisions. Smoking kills and debilitates and is a major factor in health inequalities. On average, smokers can expect to live 16 years less than non-smokers, and 35 people a day die before their time because of smoking-related illnesses—a 35-a-day habit that we have to kick. There is also overwhelming evidence of harm associated with exposure to environmental tobacco smoke. That evidence is clear and irrefutable.

Elaine Smith (Labour, Coatbridge and Chryston)

As someone who has recently, finally, stopped smoking, I wish that I had never started.

Elaine Smith (Labour, Coatbridge and Chryston)

Thank you. Is there any evidence that a smoking ban will help to prevent young people from starting to smoke, which is crucial?

Andy Kerr (Labour, East Kilbride)

There is strong evidence of that worldwide and in the work that we are doing in the Executive. We seek through the bill to denormalise smoking—to make it abnormal and unacceptable. I believe strongly that the bill will send that message.

Brian Monteith (Conservative, Mid Scotland and Fife)

The minister talked about smokers. Does he differentiate between cigarette smokers and those who choose to smoke pipes or cigars, given that 90 per cent of those who smoke cigars and 80 per cent of those who smoke pipes do not inhale, but practically 100 per cent of those who smoke cigarettes do?

Andy Kerr (Labour, East Kilbride)

I do not make a distinction, because we are talking about the protection of public health—the health of everyone in Scotland, including the 70 per cent of people who do not smoke. I am yet again disappointed by the Conservatives' response to the bill.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Will the minister join me in welcoming the coverage of all tobacco that is smoked? Will he highlight the oral health problems, such as cancers, that are associated with both pipes and cigars and the crucial role that dentists play in detecting them?

Andy Kerr (Labour, East Kilbride)

We are seeking to address those matters in the strategy that Rhona Brankin announced recently in relation to oral health checks, particularly for the over-60s. The points that the member makes are accepted, understood and uncontested by most people, with the exception of the Conservatives. I hope that the Conservatives take the opportunity in this debate to comment on the fact that their spokesperson, Mrs Milne, said that environmental tobacco smoke is "unpleasant". It is not unpleasant; it is a killer. We know that and we will act accordingly to ensure that the bill goes through.

Nanette Milne (Conservative, North East Scotland)

Will the minister give way?

Andy Kerr (Labour, East Kilbride)

I will give way in a minute. I need to make progress.

As Professor Sir Richard Doll has observed, an hour a day in a room with a smoker is nearly 100 times more likely to cause lung cancer in a non-smoker than are 20 years spent in a building containing asbestos.

As Minister for Health and Community Care I have a duty to act now to protect and improve radically the health of the people of Scotland. Banning smoking in public places sends out the clearest possible signal that we are determined to do just that. There are three good reasons why the creation of smoke-free places is good for health. First, it will make it easier for smokers to give up, because they are less likely to be tempted to light up if they do not see other people smoking, especially in pubs and restaurants where the association between drinking and smoking is so strong. Secondly, it will save the lives of people who are exposed to second-hand smoke. Thirdly, and most important of all, it will reduce the acceptability of smoking—it will denormalise smoking in our society and discourage young people from starting to smoke.

As I have said, smoke-free environments will encourage more people to quit. However, giving up smoking is hard and not everyone can do it on their own—I respect my colleague Elaine Smith for managing to do so. That is why the Executive is committed to supporting and enhancing smoking-cessation services and to bringing them into the community. We will deliver those services in communities, in places where people live and work, making it easier for them to take the first step towards quitting and increasing their chances of success. In the next few years, our funding for smoking-cessation services will increase significantly from £3 million per annum in 2004-05 to £11 million per annum by 2007-08. Those services are being enhanced and rolled out across the country as I speak. The important thing is that provision is being made to help more people in more places—both smokers and non-smokers—to live healthier, longer lives. That is why creating smoke-free environments is one of the most important things that we can do to improve Scotland's health.

Stewart Maxwell (Scottish National Party, West of Scotland)

The minister is aware of my unswerving support for the banning of smoking in public places, but is he also aware of my concern about the definition of smoking in section 4(1) of the bill? For the benefit of those who will have to enforce the measure, can the minister tell from where he is sitting which of the two cigarettes that I am holding it will be legal to smoke and which it will be illegal to smoke after the ban comes into effect?

Andy Kerr (Labour, East Kilbride)

First, I place on record again an acknowledgement of the work that Mr Maxwell has done in relation to the bill and our efforts to create a smoke-free Scotland. As we progress with the bill I am more than happy to discuss the issue of how herbal cigarettes are defined and what effect that will have on the overall competence of the bill. I cannot identify from here which cigarette is herbal and which is tobacco based. I understand and appreciate the point that Mr Maxwell is making, which is why I will seek to ensure that we deal with it as the bill develops. I am happy to sit down with him to work through the issue with our lawyers and advisers—I look forward to doing so.

In response to Stewart Maxwell's point, that is why we want the ban to be as comprehensive as it can be, to ensure that it is not just a legal measure but is easy to introduce and enforce. The smoking provisions are pro-clean air and pro-choice. The measures are inclusive—70 per cent of Scots do not smoke. There is currently no choice for non-smokers who have to socialise and work in smoke-filled rooms. Some of the asthmatics to whom I spoke recently told me that they are forced to avoid pubs. We have therefore proposed a comprehensive ban that is clear and simple to understand and enforce, and I am content that the provisions are consistent with the European convention on human rights. Therefore, there will be only limited exemptions on humanitarian grounds in the regulations. As exemptions will be dealt with in the regulations, those will not be finalised until the current public consultation is complete.

In the meantime, we are working hard with the business community to minimise the impact of the proposed ban and maximise the opportunities that the bill presents. To that end, I have established a smoke-free areas implementation group, which includes hospitality sector and public sector representation. That group, which I chair, will consider the key issues around the smoking measures. We are looking at the best ways to publicise the ban and advise businesses on the steps that they need to take; we are considering requirements for the training of enforcement officers; and we are seeking to exploit opportunities to market Scotland abroad and change its image to that of a healthy country. We are also considering how we can help businesses to exploit the opportunities that the ban on smoking in public places presents.

For the ban to be successful we must consider enforcement, and the Executive will work closely with the Convention of Scottish Local Authorities and local authorities to develop guidance that will ensure a consistent approach throughout Scotland. We recognise the importance of enforcement, and the Executive will provide additional funding to local authorities for that duty.

Ted Brocklebank (Conservative, Mid Scotland and Fife)

As a non-smoker, I have sympathy with many of the aspirations behind the bill. Nevertheless, the fact of the matter is that smoking per se is not illegal. I understand that there are clubs and other places where people who enjoy smoking come together socially to smoke. Why should those people be denied the right to do what is their choice simply because the Executive has decided that it wants clubs to be included in the bill?

Andy Kerr (Labour, East Kilbride)

The bill rests on the Executive's aim of improving public health. The public health of those in a private club, a social club, a pub and a workplace is equally important and valid for me, as the Minister for Health and Community Care, to consider. The point of the bill is the protection of public health and the denormalisation of smoking, and it is my view that Ted Brocklebank's view of the matter is erroneous.

There is good evidence that the measures in the bill will have real-life effects on the public and their families. The success of the bans in Ireland and New York demonstrates that smoking bans work, and compliance rates are high—93 per cent in the Irish hospitality sector and 97 per cent in New York.

Brian Monteith (Conservative, Mid Scotland and Fife)

The minister talks about the success of the ban in New York. Why, then, will he not consider some of the exemptions that are allowed in New York, such as cigar bars?

Andy Kerr (Labour, East Kilbride)

I refer the member to my previous answer. I am pleased, however, that he has brought up the subject of the ban in New York. Back in 2002, few people were more fiercely opposed to the ban than the outspoken James McBratney, the president of the Staten Island Restaurant and Tavern Association. He accused Mayor Bloomberg of being a billionaire dictator and a prohibitionist who would undo small businesses such as his bar and restaurant. However, in early February, Mr McBratney said sheepishly:

"I have to admit, I've seen no falloff in business in either establishment."

He went on to describe what he once considered unimaginable—the fact that customers seem to like the ban. I suggest that the Conservatives, who are making spurious arguments, should reflect on that point, see the future and join in our efforts to improve Scotland's public health.

In Ireland, sales of tobacco have dropped by 15 per cent and an estimated 7,000 smokers have quit since the ban was introduced. In New York, two years after the ban was introduced, employment in the hospitality industry had increased by 5.7 per cent, the number of openings was up and the number of liquor licenses had also increased. Therefore, as the Executive's financial impact studies show, we expect a nil or positive economic impact in Scotland, although the proposed ban is, primarily, a health measure. Our focus is on providing healthy choices, promoting a clean air environment and protecting everyone from tobacco smoke. We believe that everyone has the right to breathe clean air.

The bill also contains a range of other important health and social care measures. We will lead the way in the United Kingdom by removing existing statutory charges for eye and dental checks. That will bring significant benefits in the early detection of eye and oral disease—to which I referred earlier—and will secure an important role for community pharmacists. Patient protection will be strengthened through the extension of the range of primary care health professionals that is covered by the national health service disciplinary system and the extension of the disqualification criteria in relation to professional conduct.

John Swinney (Scottish National Party, North Tayside)

Will the minister give way?

George Reid (None, Ochil)

The minister is getting tight for time.

Andy Kerr (Labour, East Kilbride)

I am sorry. Perhaps Mr Swinney can address the matter later, in his speech.

On the other aspects of the bill, I am sure that the Executive will reflect on the report of the Health Committee, especially in relation to adults with incapacity and other such matters that it raises. I note the concerns regarding patient care and health care facilities, in response to which the bill will give Scottish ministers the power to enable health boards to enter into joint ventures that will ensure the renewal of our infrastructure at a local level for local health care. Other such matters are addressed elsewhere in the bill.

The bill will bring direct, measurable improvements to the health of the people of Scotland and provides an opportunity for Scotland to lead the way in the UK. I am delighted that so many MSPs from different political perspectives have united around the bill, which is the most important piece of public health legislation in a generation. Let us embrace this opportunity together. I hope that the Conservatives can, at last, recognise the benefits of the bill so that we can speak with the voice of the whole Parliament to ensure that we improve Scotland's public health.

I move,

That the Parliament agrees to the general principles of the Smoking, Health and Social Care (Scotland) Bill.

Carolyn Leckie (SSP, Central Scotland)

I congratulate the Health Committee, the clerks and everyone in the Parliament who has worked hard on this extensive bill and produced excellent reports. There is potential for cross-party support—except from the Tories, but I will come back to them—for a progressive, pro-health agenda, in particular on the headline intention of the bill. I do not need researchers' statistics to persuade me that second-hand smoke has a detrimental effect on health; I have only to see the immediate impact that smoke has on my daughter, who suffers from asthma, when she walks into a smoky room. I am persuaded by the health arguments of the bill, although I have some reservations. I will not dwell on those today but, as the bill progresses, I might come back to them. I am glad that the Executive is prepared to implement a policy that will, I hope, improve Scotland's health; however, I would be more impressed if that policy was presented in tandem with health policies that were even more proactive, such as the provision of free school meals.

It is unfortunate that I am unable to concentrate on the positive aspects of the bill today. The debate has been dominated by the proposed smoking ban—probably predictably and rightly—and I note that the minister spent only one minute of his speech in talking about the section of the bill that makes reference to joint ventures and LIFT—local improvement finance trust—schemes. However, contained in the bill is a section that, if not removed, is so fundamental that the Scottish Socialist Party—and perhaps others whose policies are pro-public finance—will end up having to oppose the bill. That is why I hope that all parties—although perhaps not the Tories, who I imagine think that that is the only section of the bill that is good—will support our amendment to take out the section of the bill that relates to joint ventures.

It is important to differentiate between what the Executive, civil servants and public bodies say about the policy intentions around LIFT schemes, intellectual property and so on, and what the bill allows. In answer to my written question on the subject, Andy Kerr stated:

"There is no policy intention for joint venture companies established to provide clinical services."—[Official Report, Written Answers, 21 March 2005; S2W-15136.]

Nevertheless, the bill facilitates that. It is obvious from the evidence that was given to the Health Committee that there is no support for the claimed benefits of LIFT schemes. The Executive and the bodies that are expected to implement the bill have been, at best, vague about how LIFT schemes would be implemented and what the impact would be on service provision, accountability, staffing levels and the terms and conditions of any future staff. The Executive has not ruled out staff transfer, and the Scottish Trades Union Congress/Executive staff protocol exists only as long as the Executive enforces it. The SSP believes that that is not enough protection for workers.

There are already more health centres in joint premises in Scotland than there are in England, and there is much greater potential in Scotland than in England for adverse outcomes for staff. None of the witnesses who were in favour of LIFT schemes was able to give us details of their impact on public services, but it is safe to assume that the high costs of private finance initiatives, in financial and clinical terms, will be replicated in LIFT schemes.

The returns for the private sector, which is 60 per cent dominant in the schemes, are at least double what they would be under public procurement. As we have seen with PFI, the public purse, services, patients, clients and staff pay handsomely for the private sector's bumper returns. I recommend that members read in detail the evidence presented by Dave Watson of Unison, of which I am a member, and contrast its erudition, precision and confidence with the woolly, vague, ill-informed and sometimes pathetic case submitted by the advocates of LIFT schemes.

Andy Kerr (Labour, East Kilbride)

Will the member accept on record the fact that 50 per cent of general practitioner premises are privately owned and that capital support in the public sector, particularly in health, has increased radically over the past few years? All we seek to do with these proposals is to provide another option. However, it must be the best-value option, and that will clearly form part of the assessment of such projects. We want to attract additional investment at a local level in order to proceed with good examples of partnership working such as the Dalmellington area centre, Strathbrock partnership centre and Leith community treatment centre. The measures will allow more of that activity to happen.

Carolyn Leckie (SSP, Central Scotland)

That case has indeed been made for PFI; however, it has been blown out of the water by Allyson Pollock and others. I do not need to repeat their points again this morning.

The proceedings of the so-called joint conference that was sponsored by E C Harris and 75 per cent dominated by the private sector were summarised and submitted as evidence to the Health Committee. One could almost see the slavering lips jumping off the page. I will give the chamber an example of how ill-informed that conference was. It was asserted that there was less deprivation in Scotland than in England—and Scotland, by the way, was thought to hold more exciting opportunities for the private sector as far as LIFT schemes were concerned. Those are the kind of people from whom the Executive prefers to take advice.

One crucial matter is critical mass. The participants in the E C Harris conference certainly identified that as a vital issue for them. The banks like to finance big deals, which means that health boards' capital spending priorities become determined not by clinical priorities or health needs but by the demands of the banks. They determine the conditions of the finance and therefore dictate the size of projects.

It is clear from the evidence—and from the Executive itself—that there is no detail on these proposals and no rush to flush it out.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Will the member give way?

Carolyn Leckie (SSP, Central Scotland)

I am sorry—I am in my last minute.

As a result, it is not necessary to tie up this highly controversial measure in a generally positive piece of legislation. Although the measure is worthy of public debate on its own, it has not been able to attract that because of the high-profile nature of the smoking ban.

The Tories could, and should, be isolated today. I ask the Parliament to support my amendment to ensure that at stage 1 of the bill its passage can have cross-party support—with the exclusion of the Tories.

I move amendment S2M-2667.1, to insert at end:

"but, in doing so, believes that the Scottish Executive's pursuit of further privatisation in the form of joint ventures in section 31 of the Bill compromises the general benefits to health from the Bill and potentially undermines cross-party support for the passage of the Bill."

Shona Robison (Scottish National Party, Dundee East)

I welcome this stage 1 debate. I thank all those who gave evidence to the committee; I also thank the clerks for all their hard work in helping us with what has been at times a rather difficult bill.

The bill is perhaps a lesson in why bills with miscellaneous provisions are generally not a good idea and should, if possible, be avoided. The bill is dominated by the proposals to ban smoking in enclosed public spaces; however, it also contains very important provisions that relate to the regulation of the workforce, the introduction of free eye and dental checks, compensation payments to hepatitis C sufferers and the introduction of new powers to allow the formation of joint ventures for the provision of facilities or services in the NHS in Scotland. The minister did not have an awful lot of time to address all those issues in his speech. Similarly, the Health Committee found effective scrutiny of the bill's component parts to be an extremely difficult challenge, although I must say that it made a valiant effort to do so.

I want to start with the part of the bill that focuses on smoking. It was fortunate that the committee had heard a great deal of relevant evidence during our consideration of Stewart Maxwell's Prohibition of Smoking in Regulated Areas (Scotland) Bill, because otherwise we would have been faced with a very tight timescale in which to take that evidence.

The committee took evidence from both sides of the argument and went to Ireland to see how its ban was working out. Throughout this debate, claims and counterclaims have been made about, for example, the dangers of passive smoking and the impact of a smoking ban on health and on the economy. For me, the question is very simple: on the balance of probabilities, will this measure improve public health? Having listened to all the evidence and having seen for myself the impact of a ban in Ireland, I feel that it will.

Phil Gallie (Conservative, South of Scotland)

I am well aware that the Health Committee has recently expressed concerns about obesity. Has the member seen any research that links cessation of smoking with weight gain? If so, does that offer an added health risk?

Shona Robison (Scottish National Party, Dundee East)

To be perfectly honest, that is a silly analogy. The member and his colleagues must assess whether, on the balance of probabilities, the measure will improve public health. I have to say that, at the start of the process, I had to be converted to support the measure. However, if we really listen to the evidence, we can conclude only that the measure will improve public health.

Brian Monteith (Conservative, Mid Scotland and Fife)

Will the member give way?

Shona Robison (Scottish National Party, Dundee East)

I will give way in a moment.

One important aspect of the measure is the denormalisation of smoking. So many children in so many communities see smoking as a normal activity, because people all around them do it. If we denormalise such activity, particularly in enclosed public spaces, we will give the next generation a real fighting chance in not taking up smoking at the levels that we have seen in the past. That can be only a good thing, and I hope that Brian Monteith will at least acknowledge that.

Brian Monteith (Conservative, Mid Scotland and Fife)

The member said that we can draw only one conclusion from the evidence. If so, will she explain to me how it is possible for a minister from the Labour Party in the Scottish Parliament to conclude that there should be a total ban on smoking in public places, while a Labour minister at Westminster can conclude from the same evidence that only a partial ban is required in a different part of the UK?

Shona Robison (Scottish National Party, Dundee East)

Could it be that John Reid is wrong? I will be very interested to see the absolute mess that the Westminster Government gets itself into when it tries to implement a partial ban and to decide, for example, whether a premises that serves microwaved food should be included in a smoking ban. It will be a dog's breakfast. The courts will be full of rulings to determine matters one way or the other. Because that approach will be such a nightmare, I was persuaded that an all-out ban was the way forward. I think that John Reid's assessment is simply wrong.

However, we need to consider a number of important issues. For example, people have argued that smoking will be displaced into people's homes. I do not agree that that will happen—indeed, the evidence from Ireland does not support such an assertion—but I think that the situation should be monitored effectively. In addition, because the number of people who want to give up smoking will increase as a result of the legislation, smoking cessation opportunities must be available when and where those people want them.

We must also think about enforcement. I listened to the minister's comments about the concerns that must be addressed, but the matter is crucial. After all, the ban's success in Ireland was in no small measure due to the way in which it was enforced. Enforcement was handled in a non-confrontational manner after the event. For example, if an instance of smoking in a public house was reported, that was dealt with later rather than at the time, so there was no up-front confrontation between enforcement officers and members of the public. We must avoid such situations. The Health Committee was concerned about the fact that it appears that individual local authorities will be able to determine local enforcement strategies. The minister and the Health Department must give clear guidance on what is expected in that regard.

Another ace card that the Irish have had is the Office of Tobacco Control, which was the driving force behind the package of measures that the Irish Government introduced. I believe that we need an equivalent body in Scotland to oversee the proposed changes. I look forward to hearing what the Deputy Minister for Health and Community Care has to say on that.

I realise that time is pressing, so I turn quickly to the other elements of the bill. Free eye and dental checks are welcome and have long been supported by members of the Scottish National Party. However, the committee received strong evidence—especially from the British Dental Association—that the workforce would struggle to deliver free dental checks. The minister has been questioned about that in other debates. We must acknowledge the BDA's concerns that there will not be sufficient numbers of staff to deliver the free checks.

I want to highlight the Finance Committee's strong concerns about the bill's process. It said:

"the Committee is deeply concerned that it is being asked to scrutinise the financial implications of a Bill where the staffing and service implications which crucially determine the cost do not appear to have costed in a manner that gives the Committee confidence in the figures."

We are talking about a classic cart-before-the-horse situation. When we considered the bill, we had not seen the minister's action plan or a statement of his intentions. That is not a good way in which to proceed with legislation or financial memorandums. The Finance Committee expressed very strong views on that.

I will deal quickly with hepatitis C payments.

George Reid (None, Ochil)

Briefly, please.

Shona Robison (Scottish National Party, Dundee East)

I have a number of concerns, of which the minister will be aware. I would like him to reconsider the exclusion from the compensation scheme of those sufferers who died before 29 August 2003. The committee has expressed sympathy with the view that that matter should be re-examined and I hope that Andy Kerr will do that. I also ask that the issue of residence be looked at. If someone was affected by hepatitis C as a result of receiving contaminated blood or blood products through the national health service, it should not matter where they live now; if that is how they became infected, they should get the compensation payments as of right.

I am being asked to wind up, so I will just make a brief comment on joint ventures. I am pleased that Helen Eadie welcomes the public investment trust model, on which we will seek to lodge an amendment at stage 2.

Although I have expressed reservations in certain areas, I support the bill's general principles and look forward to the amendment process at stage 2.

Nanette Milne (Conservative, North East Scotland)

The Smoking, Health and Social Care (Scotland) Bill is complex and diverse. The fact that it contains highly varied subject matter has made it quite difficult to deal with. As Shona Robison said, had the Health Committee not decided to use the evidence that it took on the Prohibition of Smoking in Regulated Areas (Scotland) Bill—which was introduced by Stewart Maxwell—in examining the Executive's bill, it would have been even more difficult for us to be ready for today's stage 1 debate.

It is clear that the Executive wants to rush through its smoking policy and I am not sure that that is wise, especially if one stops to consider how short the lead-in time to implementation will have been in comparison with the lead-in time to the introduction of the Irish legislation. In Ireland, years were spent preparing and educating the public so that they were ready for an all-out ban on smoking in enclosed public places by the time that the legislation was enacted. I do not think that the public in Scotland have reached that stage yet.

The Conservative group is generally content in principle with the proposals in parts 3, 4 and 5 of the bill, which deal with pharmaceutical care services, discipline and miscellaneous matters such as joint ventures and amendments to the Regulation of Care (Scotland) Act 2001. We agree with the recommendations of the Health Committee's report on those matters.

We have no serious difficulties with part 2, in so far as it deals with general dental services in sections 11 to 14 and with practitioner lists in sections 15 to 17, although we do not think that the Executive's recent announcements on its proposed changes to the dental service in Scotland will solve the crisis in NHS dentistry. We do not support sections 9 and 10 in part 2, which relate to free dental checks and eye examinations, nor do we agree with part 1, which deals with the prohibition of smoking in enclosed public places. Therefore, we are unable to support the general principles of what is a complex bill and we will be opposing the motion.

Jamie Stone (Liberal Democrat, Caithness, Sutherland and Easter Ross)

So far, the Conservatives have given us spurious reasons for not supporting the bill, such as those to do with pipe and cigar smoking and obesity. My father died of lung cancer and I think that the sooner the bill is in place, the sooner we will save lives. I ask the member to please give us some firm reasons for not supporting the bill.

Nanette Milne (Conservative, North East Scotland)

As someone who has worked in a thoracic unit, I am well aware of the risks of smoking. There is a difference between smoking and occasional exposure to environmental tobacco smoke, on which the research is inconclusive. There is research to support both sides of the argument; the debate is still open.

Jamie Stone (Liberal Democrat, Caithness, Sutherland and Easter Ross)

We are talking about human lives.

Nanette Milne (Conservative, North East Scotland)

I am aware of that.

We feel that the proposal for free dental and eye checks for all by 2007 would not be the best use of scarce resources. The most vulnerable people are already eligible for free checks; the difficulty lies in persuading them to attend for those checks and, in the case of dental checks, their being able to find a dentist to carry them out. Every effort must be made to ensure that those people access the services that are already freely available to them.

As we heard in last week's debate on dentistry, there are not enough dentists in the NHS to carry out the checks. Once the checks have been done, who will carry out the treatment, given that there is such a lack of NHS dentists? I agree with the concern that Eleanor Scott voiced during last week's debate, which is that it is unethical to diagnose a patient and then not treat them.

Sylvia Jackson (Labour, Stirling)

Will the member give way?

Nanette Milne (Conservative, North East Scotland)

Not at the moment.

We support the committee's recommendation on the introduction of a comprehensive dental and sight-screening programme for children at the start of their primary and secondary school education.

With regard to the proposed ban on smoking in enclosed public places, let the Parliament be in no doubt that the Conservative group wants people to have the choice of a smoke-free atmosphere in enclosed public places, such as restaurants, pubs and public transport. Great strides forward have been made in recent years without legislation. Buses, trains, aircraft and public buildings, as well as many workplaces and restaurants, are now smoke free and the licensed trade, too, is coming on board. J D Wetherspoon has led the way by introducing a smoking ban in most of its pubs.

Increasingly, choice is developing for non-smokers and those smokers who prefer smoke-free atmospheres indoors. As public demand increases, there will be more and more smoke-free premises. The licensed trade is keen to co-operate and it has indicated its willingness to make concessions and to alter premises. We want to work with the industry to enhance choice for non-smokers.

Sylvia Jackson (Labour, Stirling)

In light of what the member has told us, how does she respond to the British Medical Association? The BMA briefing says:

"The BMA fully supports the principles outlined in the Bill which seeks to provide comprehensive legislation to create smoke-free enclosed public places".

George Reid (None, Ochil)

Mrs Milne, you have three minutes left.

Nanette Milne (Conservative, North East Scotland)

I have had a discussion with the BMA and it knows my position on that.

As a lifelong non-smoker and someone who accepts that the mass of her profession is in favour of the Executive's proposals, I have thought long and hard about them in the past few months, but I remain unconvinced that legislation is the right way forward—especially at this point in time, when the licensed trade is eager to become involved in improving the atmosphere for its customers and its workforce. I fear that the bill will result in displacement of smoking to the home and an increase in home consumption of alcohol, which is itself a public health problem.

Stewart Maxwell (Scottish National Party, West of Scotland)

Will the member give way?

Nanette Milne (Conservative, North East Scotland)

I am taking no more interventions.

I feel for smokers—especially women smokers—who will be forced outside into inferior facilities, when their habit is legitimate. Several women whom I met in Ireland forcefully made the point that, since the ban had come in, they felt that were being treated like second-class citizens and they were unhappy about that. I am concerned for pensioners, particularly in small villages, who will miss the conviviality of a pint and a cigarette at their local in the company of their pals.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

Smoking kills people.

Nanette Milne (Conservative, North East Scotland)

Mike Rumbles's constituency contains small villages where there is no choice of licensed premises. I worry for the future of establishments that are unable to provide outdoor facilities for their customers. There was not a level playing field in Ireland—that was obvious.

I am forced to the conclusion that choice is better than coercion. The increasing willingness of publicans to respond to the wishes of their customers will soon result in greatly increased choice for non-smokers, while leaving some choice for those who continue to smoke. People must take responsibility for their own health and lifestyles. I have little doubt that business will respond accordingly.

My colleagues and I feel that there is an undoubted public health case for encouraging people to stop smoking and deterring them from starting in the first case. We support the Executive's plans for a sustained and vigorous campaign against the taking-up of smoking and we would give practical help, support and encouragement to those who wish to kick the habit. Believe it or not, like the Executive, we too have the ultimate goal of achieving a smoke-free environment for everyone.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

The Liberal Democrats believe that the bill will dramatically improve the health of the nation. I will first focus on the measures to introduce free eye and dental checks for all, which were a central part of the Liberal Democrats' election manifesto in 2003. Those free checks for all underpin our commitment to health promotion and early intervention. On the proposal for free eye checks, it is remarkable that, as the committee report points out,

"All those who gave oral evidence to the committee, namely, Optometry Scotland, the Scottish Consumer Council, Fife Local Health Council and the health boards (Glasgow and Highland) and all those submitting written evidence were in favour of the proposal."

There was a similar unity of view on the free dental checks—all those giving oral evidence to the committee were in favour of the proposal. Every member of the Health Committee, with one exception, believes that, if fully implemented, those measures have the potential to improve standards of oral health and reduce the number of long-term sight problems in Scotland.

I say "with one exception", because it was clear that the one Conservative member of the committee would oppose the measures come what may. It is interesting that, even when there is unanimity among those giving evidence to the committee, the Conservatives cannot bring themselves to listen to that evidence and draw the correct conclusions from it.

Nanette Milne (Conservative, North East Scotland)

Will the member take an intervention?

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

Not yet.

The dogmatic approach taken by the Conservative party to the measures in the bill is flagged throughout the report and does not go with the spirit of the committee system. Surely the Conservatives could have asked for evidence from witnesses who were opposed to the measures. Why did they not ask for such witnesses to come forward? Was it that they simply could not find anyone willing to come to the committee to support their views?

The major issue in the bill is the proposal to prohibit smoking in wholly enclosed public places. In June 2004, the Liberal Democrats became the first major party in Scotland to adopt that proposal as party policy. I am pleased that the Health Committee accepts that

"evidence exists of adverse health effects from passive smoking".

The committee's report states:

"The majority of members, therefore, support the proposal contained in this part of the bill, believing that it will help save lives."

The report refers to the "majority of members" because, once again, the one Conservative member of the committee refused to accept that passive smoking kills. That is typical of the Conservative party's approach to almost all the measures in the bill that are aimed at improving the health of Scots across the nation.

Brian Monteith (Conservative, Mid Scotland and Fife)

Can the member cite any medical evidence received by the committee that suggests that passive smoking kills?

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

I will come to that shortly. When members of the Health Committee visited Ireland to see how similar measures were being implemented there, we consistently heard the view expressed that it was important that every political party behaved responsibly by backing the health measures.

There is no dispute about the fact that passive smoking kills. In Scotland, only the Conservative party steadfastly refuses to accept the medical evidence. The attitude of the Conservative party on the issue is nothing less than neanderthal and nothing less than a scandal. The Conservative party seeks to undermine the medical evidence that passive smoking kills. It sides with the tobacco manufacturers rather than with patients and it sides with FOREST—the Freedom Organisation for the Right to Enjoy Smoking Tobacco—rather than with the World Health Organisation. Shame on the Conservative party.

Brian Adam (Scottish National Party, Aberdeen North)

Does the member agree that the arguments advanced by the Tobacco Manufacturers Association and, indeed, by the Conservative party echo those that the industry advanced when it did not accept that smoking kills? It is the same argument, recycled.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

I could not agree more. That is why it is absolutely shameful for the Conservative party to take the attitude that it has taken.

As for the medical evidence, Professor David Hole estimates that there are between 850 and 950 deaths from passive smoking every year among lifelong non-smokers in Scotland. His recent report states:

"Passive smoking represents the greatest risk to public health when compared to other forms of 'involuntary' environmental exposure."

It is because of the attitude of the Conservative party in challenging the medical evidence on passive smoking that so much time has to be devoted to the issue. In other countries, such as Ireland, where there is a responsible Opposition, no such debate is needed. All the time and effort can be focused on making sure that people are aware of the dangers of passive smoking and on getting behind the measures to tackle the problem.

In Ireland, the people are behind the measures that the Irish Government is taking. Tobacco sales have fallen by some 17 per cent, as we were informed by Ireland's deputy health minister.

Fewer people are smoking in Ireland—estimates suggest that as few as 25 per cent of the adult population are still engaged in smoking. The measures are working. The Irish public are benefiting from them and all the national political parties back them. Is it too late to ask the Conservative party to embrace the medical evidence that passive smoking kills and then to join everyone else in tackling the problem? If we are serious as a nation about tackling passive smoking, we cannot take half-measures, as they will not solve the problem.

The Scottish Licensed Trade Association argues that economics should outweigh health; it argues that we should have a partial ban. The Tobacco Manufacturers Association argues that proper ventilation of premises is the answer. Of course, neither of those approaches is acceptable for those who want to see an end to the situation in which some people cause the deaths of others through passive smoking. As the committee stated:

"ventilation would not provide an adequate alternative, because it does not remove carcinogens."

In other words, people might feel better, but they would still take in carcinogens. The same argument applies to so-called smoke-free areas.

Nanette Milne (Conservative, North East Scotland)

Will the member take an intervention?

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

I have already taken interventions from the Conservatives.

Unfortunately, we do not have time adequately to examine many of the issues that the bill raises—that is one of the problems with this type of bill. I had hoped to refer to enforcement. One issue that the committee flagged up was the hepatitis C cut-off date, to which Shona Robison referred. I hope that the minister will look again at that matter.

In conclusion, we believe that the bill contains measures that will dramatically change Scotland for the better. We will tackle the problem of passive smoking and, by doing so, we will save lives. With free eye and dental checks, we will make a difference to the nation's health through a comprehensive health promotion and preventive medicine initiative. Taken together, the measures should see us progress to a better Scotland in the 21st century. I urge everyone to give the bill their full support.

Janis Hughes (Labour, Glasgow Rutherglen)

I echo my colleagues on the Health Committee in thanking the clerks for their efforts to date in regard to the bill. The bill has not been the easiest that we have ever dealt with and I am sure that a great deal of work is ahead of us at stage 2. The support of the clerks and others will be crucial in ensuring effective scrutiny of such a diverse bill.

As a member of the Labour Party and of the Health Committee, I am delighted to support the bill, which has the potential to become one of the most important pieces of legislation that the Parliament will ever pass. However, as we have heard from other members, it is not perfect yet. In its stage 1 report, the committee expressed concerns that the bill is too diverse, as Shona Robison and Mike Rumbles said. The committee believes that the Executive should try to avoid that approach in future. My speech will focus on three of the bill's provisions: the prohibition of smoking in public places, which is the headline grabber; optometry services; and the authorisation of medical treatment.

None of us is comforted to be reminded that Scotland continues to be the sick man of Europe, but we must stop saying that and start taking action. When the committee first took evidence on a smoking ban in the context of Stewart Maxwell's member's bill, I had an open mind on the matter and was yet to be convinced that initiating such a move would bring real long-term health benefits to the people of Scotland. However, as our committee analysed the Prohibition of Smoking in Regulated Areas (Scotland) Bill and the Smoking, Health and Social Care (Scotland) Bill and as we considered the evidence, which we have heard much about this morning, from other places—most notably Ireland and New York, where the compliance rates, as the minister said, remain high—I have become ever more certain that a total ban will have a positive impact on the nation's health.

We all know the statistics, which we have heard much about this morning, and we all know the scale of the problem. In my mind, there is absolutely no doubt that the introduction of a ban on smoking in enclosed public spaces will protect the 70 per cent of non-smoking Scots from the harmful effects of environmental tobacco smoke. As other members have said, a ban will also encourage smokers to give up smoking. That is borne out by the experiences elsewhere, including in Ireland, where tobacco sales are down significantly since the introduction of the ban.

Marilyn Livingstone (Labour, Kirkcaldy)

Despite Nanette Milne's claim about the ban's impact on women in Ireland, does the member agree that the increased numbers of young women who smoke represent the real impact on women? Does she agree that the task ahead of us is to bring about a sea change to try to stop young women smoking, given the impact that smoking has on their health and on that of their families both now and in later life?

Janis Hughes (Labour, Glasgow Rutherglen)

I totally agree that the high and increasing rates of smoking among young women are a cause for concern and an issue that needs to be addressed. The one issue on which I agree with Nanette Milne is that we need to ensure that the bill will not simply ban smoking in public places, but ensure that people—and, in particular, young people—do not take up smoking in the first place. I know that the Executive has agreed to move forward in that regard.

Any debate that is inspired by the bill must inform people of the real and serious dangers to human health that are associated with passive smoking. In the parliamentary debate that followed the First Minister's statement in November, I highlighted concerns over the implications for children if parents were to choose to smoke in the home instead. Bearing in mind the similar concerns—no specific evidence was available—that were raised with us in the Republic of Ireland, the committee has recommended that the issue be monitored following the ban's implementation.

I support what Shona Robison said about the Office of Tobacco Control. In Ireland, our committee saw at first hand how that body plays a vital role in co-ordinating inspections in co-operation with environmental health departments. It was also proactive in delivering a communications strategy.

The bill will introduce significantly more than just a smoking ban, as it will also introduce many important benefits and offer us an opportunity to redefine how we deliver certain services. In particular, I welcome the bill's provisions on optometry services and I strongly support the introduction of a comprehensive sight-screening programme at the start of primary and secondary school education so that problems can be identified and treated at an early age. I speak from personal experience, as one whose mother thought that my complaints of short-sightedness in primary school were made only because I was after a pair of attractive glasses. However, I was diagnosed as being extremely short-sighted when I was screened in secondary 1 and have worn glasses or contact lenses ever since. I benefited from that screening, so I think that it is important that we screen children at an early age so that they can avoid some of the problems that can affect them in later life.

Optometry Scotland proposes that primary access to eye care should be moved away from general practice and ophthalmology clinics into community optometry practices. The organisation argues that such a move would not only allow hospital clinics more time and resources to deal with more complicated conditions, but offer patients quicker diagnosis of problems. Many optometrists feel that they could contribute more in a community setting than they contribute at the moment. The bill will allow us the opportunity to redefine how we deliver those services.

On incapacity certification, I share the committee's concerns about the bill's amendments to the Adults with Incapacity (Scotland) Act 2000. I fully support the Executive's desire to extend the range of health professionals who can issue an incapacity certificate, but I am more dubious about the proposal to extend the duration of such certificates to three years. Although the professional bodies from which we took evidence supported such an extension, a number of patient representatives expressed their reservations. We need to consider the issue carefully, but I support the committee's view that we should not change the current legislation on the duration of certificates.

I believe that the bill will have a significant and long-lasting effect on the lives of the people of Scotland. The Scottish Executive has taken the lead in the fight against ill health and it deserves to be commended for its bravery. I am delighted to support the bill and I urge members to follow suit.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

It has been said that life provides five kinds of people: those who make things happen; those who watch things happen; those who wonder what happened; those who did not know that anything happened; and those to whom things happened. As with so many subjects, we in the Parliament need to be those who make things happen for the benefit of those to whom things happened. Nowhere is that more true than in the case of the primary issue with which the bill deals. I come to today's debate as an unashamed extremist. Bertrand Russell said that only extremists create change; those who sit in the middle and agree with the herd create no change. That is why I have no tolerance for those who wish to maintain the status quo.

Let me deal with just a few of the claims that are made by the smoking lobby in one form or another. Nanette Milne claimed that the industry is keen to co-operate, but I need only refer her to the TMA's evidence to the Health Committee on the Prohibition of Smoking in Regulated Areas (Scotland) Bill. The submission states:

"The TMA does not believe it to be appropriate or legitimate"

to

"raise awareness of the dangers of passive smoking and smoking; assist in changing the attitude of the public towards smoking, and encourage smokers who want to quit smoking and help ex-smokers from relapsing."

I refer members to page 65 of the committee's stage 1 report on that bill.

Philip Morris International created the slogan:

"Today's teenager is tomorrow's potential regular customer".

We can see where that company is coming from. However, in 1999, it commissioned the Arthur D Little consultancy to study the economic impact of smoking deaths in the Czech Republic. The resulting report proudly informed the Czech Government that each smoking death provided an annual public benefit of $1,277, which would amount to $147 million each year.

How did such homicides—that is the only appropriate word—make their social contribution? Using what Arthur D Little described as

"the results of the exercise of our best professional judgement"—

that is, the judgment of the hangman—the report identified that deaths from smoking produced savings on health care expenses, housing for the elderly, social security and pensions. Even more surprising, the report's findings on the effect of smoking on employment were that

"replacing those who die early ... leads to savings in social benefits paid to the unemployed and in the costs of re-training".

Perhaps we should hand medals—posthumous medals, of course—to those selfless souls who smoke themselves to death for society's benefit. Would their families value such a medal more than the presence of the loved one who was killed by these evil peddlers of death? After all, those who make such a sacrifice are hardly volunteers for the task, when they are simply the collateral damage that is inflicted on friends in the cause of smoking company profits.

As James VI wrote in 1604—this debate ain't new—the point is that "habitum, alteram naturam". That is, habit changes nature. Four hundred years ago, James VI identified the pernicious effects of nicotine addiction, but we are fortunate to have other views that are of more social value, such as those that are expressed in the recent NHS document. The document suggests that, in 30 years' time, the smoking ban will save 406 lives a year. I believe that to be a fairly modest estimate, but I am reminded of Napoleon's demand for poplar trees along Europe's military routes to provide shade for his soldiers from the sun as they marched to war. His generals said, "But, Napoleon, it will take 30 years before the trees are high enough to deliver a benefit." He said, "Then there's no time to waste." So it is in this case. We must plan for financial impacts, positive or negative, but what must drive us is releasing our people and their families, friends and colleagues from the scourge of the addiction inflicted by the ringmasters of evil in the employ of the tobacco industry.

The NHS report identifies possible negative impacts on the viability of smaller bars. I recently visited a bar in Burghead and had some of the issues put to me forcefully. I have a few thoughts for the secondary legislation that will follow the bill, because we must protect the small village pub, which plays an important role in local societies. First, we must hold the line on exemptions—there must be none—because that would create unfair competition. However, I might have one exemption to propose later. Secondly, we must seek proactive assistance for such enterprises before implementation, to allow them to broaden their appeal, develop new markets and directly support their customers in their efforts to reduce or eliminate their dependency on tobacco. Finally, I make the entirely personal suggestion that we should consider whether transitional business rates relief could be given for a couple of years, so that bars that can demonstrate a link between reduced trading and the smoking ban can have limited compensation.

James VI said:

"Tobacco ... hath a certaine venemous facultie ... which makes it have an Antipathie against nature".

That is true.

I close with my one suggested exemption. I believe that we should consider exempting Tory social clubs from the provisions of the bill. That would make a decisive contribution to eliminating the scourge of Tories from Scotland and Scottish society, although perhaps we should protect even the Tories from themselves.

Irene Oldfather (Labour, Cunninghame South)

I did not think that I would be able to agree so whole-heartedly with Stewart Stevenson, but we may have found an area of consensus on his final suggestion for an exemption.

Today's debate represents a milestone in the short history of our Parliament. Since 1999, we have passed 83 pieces of legislation, many directly improving the lives of ordinary people, on free personal care, the abolition of tuition fees and a raft of other measures. However, none has impacted on saving lives in the way that the Smoking, Health and Social Care (Scotland) Bill will do. To my mind, it is the most important piece of legislation to impact on the health of our people in a generation.

Other members will speak about the wider provisions of the bill, but I hope that members will understand my desire, as convener of the cross-party group on tobacco control, to speak to the principles in part 1. In doing so, I want to reflect on what I believe has been a sea change in attitudes in Scotland over the six years that the Parliament has been in place.

In the early years of the Health and Community Care Committee, of which I was a member, a poll was taken of committee members' attitudes to a smoking ban. The fact that a number of us, including Hugh Henry and me, supported a full ban on smoking in public places made the evening news. Indeed, I have to say that I was not a popular person in the Market Bar in Kilwinning that weekend—sometimes we have to stand up for what we believe in. Attitudes have definitely changed in the past six years, and I hope that the work of the cross-party group, set up in 1999, has contributed to raising awareness of the debate on passive smoking and to changing those attitudes.

I acknowledge the work of individual back benchers, such as Stewart Maxwell and Hugh Henry—before he reached the dizzy heights of ministerial office—and of organisations such as the British Medical Association, Action on Smoking and Health and the trade union movement, who have assisted us in reaching the dynamic point that we have reached today. I have no doubt that, without the commitment of the Scottish Executive, the Minister for Health and Community Care and the First Minister, we would not have such a comprehensive piece of legislation. I hope that in the coming months we will maintain that position and that we do not dilute the bill under the pressure that will inevitably come upon us all.

There is a moral imperative to act. We know that smoking kills 19,300 Scots every year and that one death in five in Scotland is smoking related. We know that smoking is responsible for 33,500 hospital admissions every year. Second-hand smoke is a class A carcinogen, and that costs the NHS in Scotland an estimated £200 million every year.

Those figures represent the financial costs, but there are also human costs. No one who attended the reception at Edinburgh Castle last night could fail to be moved by the stories of how smoking had robbed loved ones of time with their relatives. They would know that this is the right thing to do. Anyone who has watched someone die of lung cancer, as I have, will know that this is the right thing to do. Anyone who has lost a mum or a dad, or a gran or a grandpa, through smoking-related illness will know that this is the right thing to do. That is why we must stand firm in the weeks and months ahead and why we must not water down the bill. I am pleased that we have the degree of cross-party support that we have for the measures.

I would like to mention a few things that I want to draw to the Executive's attention. I call them the three Es: exemptions, enforcement and enclosed areas. I hope that I have time to deal with them all; I shall certainly do my best.

Starting with exemptions, I welcome the approach that the minister has taken in stating to the Health Committee and to the Parliament that the overall principle of the bill is to move towards smoke-free environments with minimum exemptions. The approach to exemptions so far has been humanitarian—with the exception, perhaps, of Stewart Stevenson's final suggestion. I understand that if people live in a residential home, that is their home, and that residents should be able to smoke in their own room if they want to do so. The same is true of hospices and psychiatric units. However, I am concerned that there should be clearly defined and limited smoking areas in such premises, in the best interests of other patients, staff and visitors. I know that the Executive is keen to work with the Scottish Commission for the Regulation of Care to ensure that all care homes are clear that their duty of care is to vulnerable, elderly people who would be at risk.

Trish Godman (Labour, West Renfrewshire)

You have one minute left.

Irene Oldfather (Labour, Cunninghame South)

I will not be able to cover all the issues that I wanted to cover, but I would like to say a quick word about day centres. I am aware that the Health Committee's stage 1 report highlights concern about the omission of day centres from the list of exemptions. Although I appreciate that view, I remain unconvinced that day centres should be exempt from the ban. Although day centres provide a vital service, they do not qualify as places of residence. People use them on a day-to-day basis in a similar manner to attending school, college or work, and I do not think that there are sufficient grounds to grant a residency exemption. I would be particularly concerned about the precedent that that could set for other areas. I am not persuaded of that argument.

My time is running out and I do not have time to address enforcement and enclosure, but I shall write to the minister about those issues on behalf of the cross-party group.

Today we begin a journey to change the lives of young Scots. They are the generation that whole-heartedly supports the change. I have not visited one school in my area where one person has said that it is not a change that they want. We must not let them down. I urge members of all parties to support the principles of the bill.

Eleanor Scott (Green, Highlands and Islands)

The various proposals in the bill are generally ones that I and my party support. I agree with other members that it is an awfully motley collection of disparate bits of legislation, and I echo the remarks of other members and of the Health Committee that those matters would have been better dealt with separately. I strongly endorse the committee's comments on that point. Smoking is clearly the most important and innovative issue addressed in the bill and will naturally take precedence in the debate, but the other issues merit a bit more time than we have been able to give them because they have all been lumped together.

The prohibition of smoking in enclosed public spaces is something that is easily supportable, and my party has supported it from the beginning. I will talk about some of the arguments that have been used against it. One is the idea that people will smoke more at home. As has been said in previous debates, the evidence is against that. The experience of a workplace ban on smoking in Australia is that it resulted in people smoking less at home because of the greater awareness that the campaign had raised.

The process of denormalisation that the minister spoke about will be set in motion by a ban. People will smoke less in front of people—a societal change is happening anyway and the ban will ensure that it continues. I support the majority of the committee on that point.

Many of the alternatives that have been proposed for the protection of non-smokers in public places would, in my view and in the view of others, be ineffective. We have had extensive lobbying from the licensed trade. I take Stewart Stevenson's point about having to protect the small village pub, but three quarters of the residents of the small village—the three quarters who do not smoke—might be more inclined to go to the pub if they knew that it was a smoke-free environment. There might be a slight, temporary dip in licensed trade, but afterwards we could expect an increase, a healthy licensed trade and a much healthier environment.

In a previous debate, I mentioned my brief visit to Ireland and the sheer pleasure of being in a pub that was full of music, full of people and full of good humour and great conversation, but not full of smoke. The smokers occasionally went outside, but they smoked a lot less.

Jamie Stone (Liberal Democrat, Caithness, Sutherland and Easter Ross)

As Eleanor Scott knows, I have visited Ireland quite frequently. Would she not agree that when smoke is taken out of the environment in which one is eating and drinking—I sound as if I am a heavy drinker; I am not—one tastes the beer, tastes the whisky and enjoys the food more? That is a marketable benefit.

Eleanor Scott (Green, Highlands and Islands)

I agree. The pubs are cleaner and there is a much more pleasant environment. As I said, as three quarters of people do not smoke, many people will find going out to be a much more pleasurable experience.

I take Nanette Milne's point that there is a fairly short lead-in to the ban compared with that in some countries that have introduced similar bans. There is a definite need for a pre-ban publicity campaign. However, there is a lot of awareness and many people are talking about the issue. I share with members a conversation that I had with my son, who is an allegedly non-smoking student, who proposed to share a flat with some of his friends, some of whom I knew were smokers. I jarred with him a little bit about that in relation to passive smoking in the home. He said, "Well mum, they will stop anyway when the ban comes in." There is a general expectation among young people who go out a lot that the ban will be introduced and that they will modify their behaviour accordingly. That shows that the denormalisation that the minister spoke about is already starting to happen.

I agree with the committee that some enforcement issues need to be addressed. I also note the committee's comments on the crucial role and effectiveness of the Office of Tobacco Control in Ireland and the fact that we do not have an equivalent. Perhaps we do not need one, but the matter should be considered as the bill goes through Parliament. We should also consider the level of fines for breaches of the legislation.

I will move on to the proposals for free oral examinations and dental checks and eye examinations and sight tests. We have already debated extensively the dental side. As Nanette Milne mentioned, my views are on record. I have concerns about the ethics of doing examinations that may reveal a need for treatment if that treatment cannot then be provided. However, I support that part of the bill—I see that point not as a reason not to carry out the checks but as a reason to treat the dental staffing issue with great urgency. I know that the matter is being examined. The committee mentioned capacity issues, which are real.

I will put on my former school doctor's hat and talk about the committee's strong recommendation—it was a strong recommendation—that comprehensive dental and sight screening should be done at the start of primary and secondary school. I agree with that, but in the case of sight screening I make a plea for it to take place earlier. When we screen vision or screen for eye pathology in young children, we are not necessarily looking only for their need for glasses to be able to see the blackboard or for the kind of eye conditions that occur in older people.

We are looking for the condition of amblyopia, where there is a permanently poor-sighted eye. That can result from a squint, when the image of one eye is suppressed because otherwise the child would see double, or when the two eyes are very unequal in terms of long-sightedness or short-sightedness, so again the image is suppressed.

The condition can be treated—we probably all know of children in our families who have had to have patching on an eye to treat the problem, for example—but that must be done at an early stage. There is a window of opportunity, which decreases. By the time screening takes place, a primary 1 child might be coming up to their sixth birthday, which is getting a bit late. I make a plea for screening to be done earlier. I also ask for the staffing implications of carrying out screening at that stage to be considered, in particular the possible need for more orthoptists, because they will pick up children who cannot be tested effectively in the community or who will need follow-up treatment.

I have a lot of sympathy for Carolyn Leckie's amendment. I share some of her concerns about the impact of joint ventures and LIFTs, in particular about their use in future in ways that were perhaps not intended. I intend to support the amendment in Carolyn Leckie's name and also the bill.

Brian Monteith (Conservative, Mid Scotland and Fife)

It is a pity that there is not more time for the debate. Given that the bill is so broad, a great deal of issues and details need to be explored. Matters such as the provision of free eye tests and free dental checks are worthy of debate in themselves. I would have preferred an all-day debate: if the bill is the landmark that it is regularly claimed to be, that would have been fitting.

I make two simple observations on eye tests and dental checks. First, some opticians are already prepared to offer free eye tests—I pulled out an advert from Yellow Pages this morning that shows that Dollond & Aitchison offer free eye tests, as other opticians have done before them and continue to do. That means that taxpayers' money will be poured down the drain, or poured into the bank accounts of the opticians, many of which—as I am sure Carolyn Leckie will be aware—are rather big businesses.

Secondly, why should I, on £52,000 a year, be given a free eye test by the taxpayer when before the bill I was content to pay for it?

Sylvia Jackson (Labour, Stirling)

Will the member give way?

Brian Monteith (Conservative, Mid Scotland and Fife)

No, I am making a point. I will see if I have time for interventions later.

Why, when to attract my custom opticians offer me all sorts of attractive deals—two for the price of one, free sunglasses and free eye tests—and I am willing to pay more than £400 for a pair of spectacles, should the taxpayer pay someone such as me £20 to have an eye test?

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

The answer is simple. The free eye test will lift public health throughout Scotland. Can Brian Monteith answer the point that I made to him directly earlier on? Is anybody against—

Brian Monteith (Conservative, Mid Scotland and Fife)

I will come to that point. It is clear that if one goes round opticians and dentists and says, "We will pay for some of your services directly instead of you having to ask the customer to pay," it is a no-brainer. They will not submit evidence and say, "Of course not"; they will take the taxpayers' money. Mike Rumbles must think that they are mugs if he thinks that they would do anything else.

I will move on to the stigmatisation of cigarette smokers—I say that because that is what the ban on smoking in enclosed public places is about. The minister talked of denormalisation, but I prefer to call it stigmatisation. It is about trying to ensure that because it is more difficult to smoke, people begin to give up. Behind the proposal is an issue that has not been addressed, which I touched on in an earlier intervention. How is it possible for two different ministers to reach two different conclusions about what action to take when provided with the same evidence about the dangers—I say "the dangers"—of environmental tobacco smoke? One minister, at Westminster, believes that the evidence is inconclusive and that a partial ban is required, and another minister, in Edinburgh, believes that the evidence is conclusive and that a total ban is required. The evidence is the same—and, by the way, it is not medical evidence; it is statistical evidence and it is disputed.

The total ban is not about protecting people; it is about stigmatising cigarette smokers, making it harder to smoke and bullying them into giving up. If the advocates of a total ban could get away with it, they would introduce a ban on the sale of tobacco. The minister talked of prohibition. In the America of the 1920s, there was prohibition and they had speakeasies. In the Scotland of the noughties, we will have the prohibition of cigarette smoking and we will have smokeasies.

Scottish people are generally law-abiding and I expect them, generally, to observe the ban. However, I also expect that, in some instances, people will be turned into criminals because they choose to smoke in enclosed spaces. For that reason, it is important that amendments will be made to the bill to broaden the exemptions. It is important that private clubs should be able—as has been suggested in England—to choose to allow smoking.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

We could exempt Tory clubs.

Brian Monteith (Conservative, Mid Scotland and Fife)

I say to Mr Stevenson that, were there to be an exemption for Conservative and Unionist Party clubs, they would become particularly popular. I have no doubt that, if offered the opportunity, Mr Stevenson would not vote for that.

There could be other exemptions for cigar shops, cigar bars and premises with a high standard of ventilation. As in Japan and Italy, where they have smoking legislation, such exemptions could make a difference.

We must act to protect public health; I do not advocate doing nothing and I do not support the status quo. However, we should reject coercion and we should be conscious of civil liberties. This bill marks out Scotland as an intolerant and less free society. For that reason, I cannot support it in principle.

Duncan McNeil (Labour, Greenock and Inverclyde)

The Smoking, Health and Social Care (Scotland) Bill will bring direct improvements to the health of people in Scotland. I am part of the majority on the Health Committee which believes that the bill will have a positive impact and will help to save lives.

Members who sit on subject committees might agree that some evidence-taking sessions are less than illuminating, consisting largely of people whom we would expect to be giving evidence giving the evidence that we would expect them to give. The Health Committee's stage 1 evidence on this bill—on part 1 at least—was a prime example. In one corner, we had the fundamentalists; in the other, the libertarians. Round after round, they traded statistics and counter-statistics and bashed each other with studies and counter-studies. In the end, they boxed themselves to a standstill.

Did anything emerge from that? It is pretty clear, and accepted by all, that active smoking kills. We knew that already. Passive smoking can kill—especially when people are exposed to high levels of second-hand smoke. As the minister pointed out, people who live with smokers are at a greater risk of smoking-related disease. However, that is not the same as saying that environmental tobacco smoke in public places is, on its own, going to kill people. It would be interesting to see the results of a study that focused purely on people who were exposed to tobacco smoke only, for example, in a pub on a Friday night. We did not see such a study.

We heard a lot about the Irish experience. Some elements in the chamber are desperate for us to copy Ireland at every turn. I sometimes think that, to have an influence in Scottish politics, a person would have to be elected to the Dáil. However, in this case, we could learn from the Irish approach. As the committee heard, the Irish did not turn down the choice versus health cul-de-sac. They bypassed the argument between the right to smoke and the right to clean air. That is an argument in which we have become bogged down, turning the debate into one between smokers and anti-smokers.

Instead, the Irish concentrated on the working conditions of employees in the hospitality industry. By doing so, they united smokers and non-smokers in support of the ban. We all know that employees do not have the choice that customers have over whether to enter particular premises. Employees also spend far longer in such environments or atmospheres than their customers do; sometimes employees will spend long periods in those atmospheres seven days a week.

I have campaigned across the whole range of industries for the right of workers to have a safe working environment. If the health of workers in the hospitality industry is damaged by working in a smoky environment, I cannot stand here and argue that they should be denied the same protection that is afforded to every other worker.

However—I borrow an argument from the Green Party when it talks about genetically modified crops—just because we can do something does not automatically mean that we should do it. We must ensure that smokers do not feel stigmatised by this process. We cannot just impose our will from on high; we need to win smokers round to our arguments and we need to take them with us. If we are to tackle the large number of active smokers, we need to offer them the opportunity to become part of the debate. As others have said, we cannot marginalise them.

We cannot sweep the problems of addiction under the carpet. We all know that most smokers would like to stop. All smokers wish that they had not started and I think that they would back moves to help them to stop. They would also want to prevent their children and grandchildren from starting in the first place, and to protect them from being harmed by smoke at their workplace.

We are serious about tackling the damage that is done by tobacco and I think that smokers will join us in welcoming new legislation. Smokers and non-smokers will also support us in using the powers that we already have. What about illegal sales of tobacco to children? We know that it happens—from ice-cream vans to corner shops.

Smokers and non-smokers disapprove of that, so let us have some action.

Should we allow anyone—including parents and teachers—to stand smoking in school premises or adjacent to them as they wait to pick up children? We can see that happening as we go by our nurseries and schools. We have powers and we should use them. Smokers and non-smokers would agree that it is wrong to set that bad example.

We need to reduce the harm that tobacco does in our communities—particularly in communities such as my own, where smoking is clearly killing people who are too young to die. The need to reduce harm is not up for discussion. In new legislation, we must not worry about the comfort or the agendas of unelected lobbyists, however well-meaning they might be. Instead, we must pursue the principle of reducing smoking and the damage that it does in our communities.

Stewart Maxwell (Scottish National Party, West of Scotland)

What a long way we have come since June 2003, when I first proposed a ban. At that time, I was ridiculed by members in this chamber and, unfortunately, by members of the illustrious press corps. However, less than two years later, we have almost unanimous support for such a ban. I am glad that we have reached this point so soon. This is a great day for Scotland, as we take the first tangible step towards a smoke-free future and towards protecting the health not only of the current generation but of future generations.

I express my gratitude to all the people and organisations outside the chamber who have fought for smoke-free laws for a long time. I also express my gratitude to the Health Committee for its work not only on this bill, but on my bill.

However, I disagree fundamentally with the committee's comments in paragraph 38 of its report. As Irene Oldfather suggested, the idea that day care centres should be exempted from the ban makes no sense whatsoever. At the committee, the Minister for Health and Community Care argued correctly that allowing the exemption would lead to complex problems. It would also be a slippery slope. If day care centres are exempted on the ground that some people may spend some time during the day there, the way will be clear for all sorts of other places to be exempted on the same ground. A day care centre is not a temporary home; it cannot reasonably be argued that it is.

Turning to the debate over what has been called the level-playing-field approach and to the debate over enforcement, I believe that the two are inextricably bound together. Throughout the debates, one of the big arguments in favour of a complete ban has been that it would create a level playing field. The committee took much evidence on that point and the Executive has used the level-playing-field argument to support its bill. The committee makes it clear that it agrees with that line of argument and it states expressly that any partial ban would not be as effective as a full ban. I agree with that absolutely. We need a comprehensive, clear and—most important of all—easily enforceable ban in order to protect people from the dangers of second-hand smoke.

Unfortunately, the Executive's bill does not achieve a level playing field because it contains a loophole that will allow smoking to continue in enclosed public places. Everyone is well aware of my unswerving support for a ban on smoking in enclosed public places. The minister is aware of my concerns on the definition that is contained in section 4(1); I wrote to him to point out the problem as I see it on the matter. The minister is also aware of my intention to lodge an amendment at stage 2 to close the loophole.

The bill, as it is drafted, fails to ban all smoking in enclosed public places. Although the bill bans the smoking of tobacco cigarettes, it continues to allow the smoking of non-tobacco cigarettes. The definition in my bill was not limited to the smoking of tobacco but covered all smoking. I urge the Executive to support the amendment that I will loge at stage 2.

I intervened on the minister to ask him whether he could tell me which of the two cigarettes that I held up for his inspection was covered by the bill and which was exempt. He could not give me an answer. I will hold them up again for members' inspection. It is clear to see that they look identical; it is impossible to tell which one will be exempt. If the minister could not differentiate between them—certainly, I cannot—how will enforcement officers, the police and other licence holders be able to tell the difference?

The point is important because, as the bill stands, the ban will not be as easily enforceable as it could be. The cigarette that I am holding up is a herbal cigarette—it contains a plant other than tobacco. A herbal cigarette produces tar and carbon monoxide just like a tobacco cigarette, yet it will remain perfectly legal to smoke this cigarette in an enclosed public place after the ban has been introduced.

The smoke from herbal cigarettes will affect non-smokers, particularly those with asthma and other chest problems or breathing difficulties, in exactly the same way that tobacco smoke does. The lack of voluminous research on non-tobacco cigarettes is sometimes used as an argument that those cigarettes may be less dangerous to health than tobacco cigarettes are. The argument is flawed, however. Given that herbal cigarettes contain similar and sometimes higher levels of tar and carbon monoxide than tobacco cigarettes do, we can easily deduce that herbal cigarettes are at least as dangerous as tobacco cigarettes are and perhaps even more so.

The Lancet published a study into the effects of smoking non-tobacco cigarettes, in which it said:

"Our data showed that smoking these vegetable-based cigarettes led to a similar degree of exposure to carbon monoxide as smoking tobacco cigarettes, and may exceed the latter. Thus this product is a potential hazard to health."

Others agree. The British Lung Foundation stated:

"A lot of people try herbal cigarettes because they think that since they don't contain nicotine they are safer. Nicotine is addictive, but it's the other stuff that gives you lung cancer and emphysema."

Brian Monteith (Conservative, Mid Scotland and Fife)

The Federation of Scottish Theatres has raised its members' concerns about the use of cigarettes on theatre stages. It has been suggested that the alternative would be to use herbal cigarettes. If the bill contains no exemption for the use of tobacco on stage, does the member concede that it should contain an exemption for the use of herbal cigarettes on stage?

Stewart Maxwell (Scottish National Party, West of Scotland)

No; I do not accept that proposal. I am sure that another technical way can be found of producing smoke from a small tube without the person who is at work on the stage having to inhale tar, nicotine or any other hazardous substance.

Because of the evidence about the dangers of herbal cigarettes, the Federal Trade Commission in the United States of America has ensured that companies display the following warning prominently on their products:

"Herbal cigarettes are dangerous to your health. They produce tar and carbon monoxide."

In Ireland, the council of the Pharmaceutical Society of Ireland stated:

"in light of recent information on the serious health risk posed by herbal cigarettes, it is no longer ethical for herbal cigarettes to be sold from Irish pharmacies".

The secretary of the society said:

"herbal cigarettes ... pose just as serious a health risk as tobacco products".

If our real intention is to create smoke-free enclosed public places and workplaces, we must change the definition of smoking in the bill. If we want to win the health war against smoking, we must pass legislation to ban all smoking in enclosed public places and not introduce a partial ban on some smoking products.

The biggest health gain that we can achieve with the bill is to denormalise smoking in Scotland, and we can achieve that only by amending the bill so that it covers all smoking. That is the only way of ensuring that there is no possibility that anyone can try to get round the provisions of the bill.

Banning smoking in enclosed public places will be a major step forward for public health and all members should support it. However, excluding some smoking products, even though they produce tar and carbon monoxide and have been shown to damage health, will mean that we go only 90 per cent of the way. Let us go 100 per cent of the way: let us ban all smoking in all enclosed public places.

Kate Maclean (Labour, Dundee West)

I apologise to the chamber for being late this morning; unfortunately, I was held up in traffic. I apologise to the minister for missing the first part of his speech. I will scrutinise the Official Report to ensure that I have not missed anything.

The issue of smoking has been well covered this morning. Apart from a brief response to a point that Irene Oldfather and Stewart Maxwell made, I will concentrate on a different part of the bill. I agree with Shona Robison and the other members who said that the provisions of the bill are too wide. It was difficult for the Health Committee to scrutinise the bill fully; in fact, if the committee had not taken evidence on a ban on smoking in its scrutiny of Stewart Maxwell's bill, it would have been impossible for us to produce a stage 1 report in the time that was available to us.

I fully support a ban on smoking in enclosed public places and, like other members, I support as few exemptions as possible. In paragraph 38 of its report, the committee recommended that adult day care centres be treated differently, and I want to explain the reason for that recommendation. If the Executive is to grant exemptions on humanitarian grounds, adult day care centres should be included in that category of premises. I am not saying that that should be the case for every centre in which adults spend the day, but some adult day care centres are, in effect, people's home for the day. If carers are on respite care or away for therapeutical reasons, the person in question has no choice of where they go for the day as they cannot choose to go somewhere else. It is important that members are aware that the Health Committee had that specific group of adults in mind when it made the recommendation in paragraph 38. The Executive's policy of exemptions on humanitarian grounds should cover such day care centres, or consideration should at least be given to that recommendation.

Stewart Maxwell (Scottish National Party, West of Scotland)

Surely the comments that the member has just made undermine her argument?

She spoke about a small number of people in a given set of circumstances, yet that situation will cause real problems in the attempt to achieve a level playing field. The committee agreed that the bill needs to be obviously and easily enforceable, but the member argues that there should be exemptions in some places, at certain times and for certain people. Surely that proposal is too complicated and would be difficult to enforce?

Kate Maclean (Labour, Dundee West)

There are problems when we look at the issue on humanitarian grounds. I was not suggesting that we do not look at things for humanitarian reasons, but that, if we do so, we will get no black-and-white solutions and there will be grey areas in between. Perhaps the issue should be monitored after the bill has been enacted. If we look at things for humanitarian reasons, it is not always easy to decide what to do. I understand why people are confused on the issue. That said, the Health Committee made that recommendation and I support it.

In relation to oral health assessments and eye examinations, I will focus on paragraphs 89, 90 and 91, which address uptake of services. In paragraph 89, the committee recommended follow-up work, including advertising, to encourage uptake. We also made reference to the nature of the new eye examination and oral health assessments. We want to ensure that they will provide positive health benefits. The committee heard evidence about the huge difference between an eye test and a proper eye examination. The point is crucial and I look forward to the minister clarifying it. I look for him to do so not today, but after the consultation that must take place with the professional bodies on the subject.

In paragraph 90, we refer to vulnerable groups, which is an issue that I feel strongly about. Some groups are difficult to assess and others can be far more time consuming. I am thinking of adults with learning disabilities or people with Alzheimer's disease. It is important that time and funding are given so that those people can get the full benefit of an eye test and oral health examination—they should benefit from them in the same way that everybody else will.

We should encourage uptake from people in more disadvantaged areas; historically, they do not take up any type of screening even although they have always had it for nothing. That point was demonstrated in some of the figures on oral health in more disadvantaged areas that were quoted in last week's dental debate.

I feel particularly strongly about the introduction of a comprehensive dental and sight-screening programme for children. I am pleased that the committee included that subject in the report and that it made a strong recommendation on it.

Although I will concentrate on sight screening, the argument applies equally to dental checks.

The cross-party group on visual impairment, which I chair, and the Royal National Institute of the Blind Scotland have campaigned for several years on sight screening for pupils when they enter primary and secondary school. The bill is a convenient vehicle with which to introduce that measure. One in five children has significant undetected sight impairment, in spite of the fact that they are entitled to free sight tests, spectacles and eye care if they need them. I strongly support the recommendation, and look forward to hearing the minister's comments. The minister did not refer to the recommendation in his opening speech, but being an eternal optimist I assume that that is because he intends to lodge amendments at stage 2 to address the committee's recommendation. I am sure that if he does not do that, somebody else will.

I look forward to scrutinising the bill further at stage 2. I fully support the principles of the bill.

Donald Gorrie (Liberal Democrat, Central Scotland)

I have two preliminary points. First, I agree with those who oppose bills in which a lot of things are put together. Bills should not be like a plate of hors d'œuvres. I hope that ministers will take account of the fact that it is much better to have a single bill on a single issue. Secondly, I regret that Stewart Stevenson mentioned James VI, as I had intended to do so. James VI is an underrated gentleman, who not only opposed smoking but tried to limit the growth of London; those are two very good ideas.

I will talk mainly about smoking, because I have studied the issue and have strong views on it. I welcome the dental and eye checks and various other parts of the bill.

A bill that bans anything causes us, as liberals, concern and we have to think carefully about it. Liberals are not people who wander round the world seeking to ban everything. However, it is obvious that there are occasions on which it must be accepted that a ban is the right thing. The proposed ban is acceptable for two reasons. First, we have to balance one person's right to breathe clean air with somebody else's right to smoke. Those two separate freedoms are in conflict. The issue is not just the deaths, which are important, but the unpleasantness. I have a colleague in another field who is asthmatic, and she cannot go into any pub in Edinburgh. It was a great pleasure to go into a pub in New York last year and breathe clean air. Officials in New York are happy with the success of their ban. The issue of two rival freedoms is important.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Having quoted James VI at Donald Gorrie, I wonder whether I might also quote Molière:

"The greater the obstacle, the more glory in overcoming it."

In relation to smoking, the obstacle is clearly great. Does not Donald Gorrie accept that, in this context, the rights of non-smokers and the support that we should give to smokers to cease overwhelm any countervailing requirement?

Donald Gorrie (Liberal Democrat, Central Scotland)

Yes. In the end, as I was going to say, we come down on the side of the non-smokers. There are various red herrings. There is the question of partial bans and voluntary systems, but they do not work. Smoke does not recognise partial bans; it goes everywhere. Neither do partial bans or voluntary systems deal with people's working conditions, which are important.

The second reason for the ban being acceptable is that sometimes severe legislation is necessary to improve public health. The greatest steps to improve public health in Scotland were taken by the Victorian public health pioneers who insisted that there be decent drainage systems. I am sure that there was great opposition from the Conservatives of those days saying, "We have the right to put up houses with no drainage, and you can have water and sewerage systems that join up together." Severe action has to be taken to deal with public health issues. I try to represent citizens in Central Scotland, many parts of which have a really bad health record as a result of smoking, cancer, asthma and other problems. We must pay attention to that. There is the question of balancing freedoms, but it is important that we do something strong to improve public health.

I do not conceal the fact that the objective should be to reduce smoking overall. We want to persuade people not to smoke. Some of the evidence to support a ban in public places comes from other countries, where bans have helped to reduce smoking overall. People take up smoking because of peer pressure—at 12 or 14, they do what is cool and they smoke. We must create the idea in people's minds that it is not cool to smoke.

I am not keen on the word "denormalise", but I am keen on the idea. Propaganda has a bad name, because of Joseph Goebbels and spin doctors, but propaganda in a good cause is a good thing. Religions use propaganda, and on the whole it is helpful. We need to have strong public education. I do not know whether we need an Office of Tobacco Control like the Irish have, or some other system, but we need to have a strong public education programme, which will lead to support for the bill. The bill will do a huge amount of good for Scotland and I am happy to support it.

Sylvia Jackson (Labour, Stirling)

It gives me great pleasure to speak in this important stage 1 debate. I am not a member of the Health Committee, but the Subordinate Legislation Committee, of which I am convener, has examined the delegated powers provisions of the bill. Almost 30 such powers were examined, and after correspondence with the Executive only one issue remains, to which I now refer.

The bill seeks to create offences of smoking or permitting smoking in no-smoking premises. What constitutes "no-smoking premises" is left entirely to regulations that will be made under sections 4(2) and 4(7). The Subordinate Legislation Committee recognised the need for the definition of "no-smoking premises" and exemptions to be contained in regulations rather than be on the face of the bill, in order to provide the necessary flexibility. The committee also acknowledged the high level of consultation that was undertaken on the first draft regulations that are proposed to be made under the bill. However, the committee was concerned that there should be sufficient consultation on future regulations that seek to amend provisions. The committee was keen that consultation on future substantive regulations should be as wide as that which was conducted on the first regulations.

As the minister knows, the committee has written to him suggesting enhancing the power at section 34(4), so that while the Executive will be required to consult such persons as it considers appropriate before laying a draft of an instrument, it will also be required to circulate the draft instrument. The committee accepts the potential problem with developing procedures that will be applied in every circumstance, even with minor technical changes, and therefore suggests amending the bill to require that draft instruments be circulated only when substantive changes are proposed.

Behind specific issues in the bill lies the general issue of ensuring that there is adequate consultation on sensitive and important matters when new instruments are being introduced. The Minister for Parliamentary Business knows about that and other issues that are being considered as part of the Subordinate Legislation Committee's on-going review of the regulatory framework. We welcome her readiness to have on-going dialogue on the issues.

I will share with members representations that have been made to me on the bill. One community council stated:

"We all support the idea of a ban, mainly because of the health risks associated with active and passive smoking. Several of us stated that we would be more likely to use the local pub if it were smoke-free".

Another community council stated:

"it was unanimously agreed that something has to be done to discourage smoking—especially in young people."

Section 10 deals with eye tests. I have been approached by Optometry Scotland, which asks that the general ophthalmic services sight test and the eye examination be defined. It also asks that the two be inextricably linked, fully resourced and introduced together. The minister is aware of the good work that is being done in the Glasgow integrated eye care scheme and I am sure that he would be willing to consider how such schemes could be extended.

As Irene Oldfather said, we must thank the many people—such as Stewart Maxwell and those in various associations—who have been involved with the bill and in earlier work.

I return to what the Conservatives do not want to hear—the points that BMA Scotland makes on the smoking ban:

"The BMA fully supports the principles outlined in the Bill which seeks to provide comprehensive legislation to create smoke-free enclosed public places.

Smoke-free enclosed public places would save hundreds of lives each year and reduce the impact of chronic disease on individuals and the health service. Recent research published in the BMJ reports that passive smoke kills 30 people a day in the UK."

We must support the bill to improve public health in Scotland.

Carolyn Leckie (SSP, Central Scotland)

I start with the bill's provisions on smoking. Nanette Milne suggested that publicans were moving voluntarily, but I make the point to her—unfortunately, she is not in the chamber—that publicans are responding only under the pressure of the political debate. If it were not for that debate and pressure, publicans would not respond with voluntary bans.

The tobacco lobby has been ably represented by the Tories—

Stewart Stevenson (Scottish National Party, Banff and Buchan)

Surely not.

Carolyn Leckie (SSP, Central Scotland)

Perhaps the lobby has not been ably represented and the Tories could have done a better job.

The tobacco lobby, which disputes the health effects of passive smoking, lied and deceived people about the effects of smoking for decades. The Tories take their cue from the people in that lobby, who are culpable for the deaths of thousands who were hooked on tobacco when the tobacco companies, which knew fine well the harm that they were causing, issued propaganda claiming that smoking had health benefits.

That is why e-mails to me from the tobacco lobby go straight into the junk folder, which is where they belong. Obviously, in the case of the Tories, such e-mails go straight into the members' speeches. I have heard Tories argue that to have smoking and voluntary no-smoking pubs side by side is an alternative to a ban—Phil Gallie and I were on opposing sides in a debate on the matter at the University of Strathclyde, and he made that suggestion—which demonstrates zero concern on the Tories' part for the workers in such establishments. When Phil Gallie was challenged on that point, he offered the justification that pub workers have the freedom to choose to work in smoke-free pubs. Unfortunately, workers rarely have any choice about where they work or the jobs that they do. Moreover, history shows that workers will invariably compromise health in favour of income and that employers will do the same in favour of profit.

Like other members, I am concerned that the bill's broad-ranging nature has reduced the opportunities for full and proper public and parliamentary scrutiny and debate. I hope that the burying in the bill of other controversial measures was not an intentional ploy to reduce public involvement, but I am a suspicious person and think that that might have been the case. The fact that it is impossible for members to cover all the parts of the bill in their speeches demonstrates that there is a problem.

Brian Monteith asked why he should get a free eye test. I presume that he pays taxes—perhaps we should check that—and that that is how he will pay for his eye test but, as far as I am concerned, he does not pay enough tax. He should not worry, however, because if the Scottish Socialist Party ever gets its way, he will pay more taxes and we will help him to avoid having a guilty conscience.

Brian Monteith (Conservative, Mid Scotland and Fife)

Carolyn Leckie has still not answered my point: if I am prepared to pay £20 for my eye test every six months, why should the taxpayer pay for it instead of me?

Carolyn Leckie (SSP, Central Scotland)

Brian Monteith is a taxpayer and can pay for his eye test through his taxes. What is more, he will pay more than poorer people and lower-waged people, which is how it should be in the great socialist paradise.

In response to Andy Kerr's comments, I say that public borrowing is much greater value for money for the simple reason that it is cheaper. PFI and LIFT are the only additional money, because the Executive ideologically restricts the ability of health boards and other public bodies to take the public procurement route. As Dave Watson of Unison said:

"The only guarantee in PFI is that the bankers always get their money."—[Official Report, Health Committee, Tuesday 8 March 2005; c 1752.]

I would have expected Janis Hughes, as a sister Unison member, to deal with section 31 in her speech—especially as Dave Watson has acted as her election agent in the past—but, unfortunately, she did not.

The greatest danger of section 31 is that business interests will outweigh public need. The section will replicate the detrimental effects of PFI on public services that we have seen in many documented examples, such as the Skye bridge, the Edinburgh royal infirmary and innumerable schools projects.

Elaine Smith (Labour, Coatbridge and Chryston)

Will Carolyn Leckie give way?

Carolyn Leckie (SSP, Central Scotland)

I am sorry, but I am in my last minute.

The Scottish Trades Union Congress has raised serious questions about the potential for conflicts of interest in the running of LIFT schemes. There are already examples of that in England, where the fiduciary duty that all directors have to shareholders can mean that decisions on the leasing of premises are made on the basis of the rent that the prospective tenants are willing to pay rather than as a response to clinical need and as part of planning the service that the community needs to be delivered from those premises.

LIFT will distort clinical priorities, and I encourage the Executive to remove section 31. I appreciate Eleanor Scott's support for our amendment and regret that, so far, no other member has addressed it. It is a reasonable amendment and, as I have heard no arguments against it, I presume that it will attract support from other parties.

Robert Brown (Liberal Democrat, Glasgow)

I am delighted to close the debate for the Liberal Democrats and to speak on the bill's provisions, including the central ban on smoking in enclosed public places, which is probably the most important public health measure in a generation.

It is also important to highlight the implementation of the key Liberal Democrat commitment to free eye and dental checks—I will deal with Brian Monteith's point on that. The main reasons for the provision are health promotion reasons: to increase take-up of such checks and to ensure that no one is financially debarred from taking them up.

I will deal primarily with the debate on the smoking ban. It has been an unbalanced debate because of the Conservatives' bizarre and extreme commitment to the line that they have taken on the matter. We should be talking about ways in which we can make the smoking ban effective and we should be considering the other measures in the bill, but we have not been able to do that because of the way the debate has been dominated by the need to answer Conservative criticisms.

I will not rehearse the medical arguments; although the tobacco industry can twist and duck all it likes, it is clear that smoking kills. Smoking is the biggest contributor to premature death in Scotland through coronary heart disease and lung cancer. In answer to Nanette Milne's attempt to bring a feminist aspect into the Tories' argument, I point out that a recent report from NHS Scotland indicates that more than 75 per cent of deaths that are related to environmental tobacco smoke are among women. She should take that fact into account before she finalises her views on the matter.

Smoking is closely associated with shorter lifespans and greater illness in deprived areas, where addiction is greater. Tobacco is heavily addictive—possibly more addictive than heroin—and extraordinarily difficult to kick. My mind is clear that the time for half-hearted, halfway-house measures has long since passed. Incidentally, if I had to choose between taking advice from the BMA, the various medical unions, the NHS, Macmillan Cancer Relief and all other medical interests on one hand or Brian Monteith on the other, my mind is clear about which advice I would take.

I will deal with the social effects of a ban on smoking in enclosed public places and workplaces. I have no sympathy with the tobacco industry or its funded mouthpiece, FOREST, which have distorted scientific investigation of the issue for far too many years. It is clear that the effect of a ban would be to cut tobacco consumption substantially, which is why they are against it and I am for it. Surveys throughout the world indicate that a workplace ban is likely to reduce the number of smokers by something like 4 per cent, and to reduce total tobacco consumption by something like 29 per cent per employee. Similar effects could be predicted from a ban in enclosed public places.

Many of the people who will be saved from addiction will be young people, such as students, who smoke socially or to appear cool. I particularly dislike the idea that 17, 18 or 19-year-olds who are smoking in pubs are exercising a free and mature choice, fully aware of the risks that they face: they are not. They believe that they will live forever and are seduced by the culture that the tobacco industry has done much to foster.

On the other hand, I have quite a lot of sympathy for publicans who worry about their livelihoods, but I think that they are wrong. The reduction in bar sales in Ireland following the ban there is often cited, but although the reduction that was reported by the Central Statistics Office in Ireland was 2.6 per cent, there had been a long-term decline in bar sales, which had gone down by 7.1 per cent in the year before the ban was introduced.

Brian Adam (Scottish National Party, Aberdeen North)

Does the member agree that, as well as the introduction of the smoking ban in Ireland, there was a significant change in the licensing laws with regard to children being allowed in bars, and that that curfew is believed by many people to have contributed to the decline in bar sales?

Robert Brown (Liberal Democrat, Glasgow)

That is correct.

A similar picture emerges from consideration of the number of businesses in the sector that went bust. After the ban, the number was slightly smaller than it had been before the ban. The recent study that was commissioned by NHS Scotland and to which I referred earlier suggests, if anything, that the effects of the ban will probably be economically neutral for the hospitality industry. The impartial observer would be entitled to conclude that, although the position might vary between different establishments, a tobacco ban is highly unlikely to damage pubs and restaurants across the board. Indeed, there is every reason to think that it might attract back some of the 70 per cent of people who are non-smokers and who have in the past been put off going to smoky bars. That sounds like a much more solid customer base on which to build for the future.

There is an interesting point to be made about public support. We have heard various statistics—of course, the figures depend to some extent on how the questions are asked—but, according to the Scottish Executive's survey, 56 per cent of people support the ban. The foreign experience is that support for a smoking ban rises substantially after it is introduced. In Ireland, support went from 59 per cent to 93 per cent after the ban came in. That links to the 97 per cent compliance with the new laws that is reported in Ireland. It is perfectly natural that those two elements are connected.

I have a huge amount of sympathy for smokers. Tobacco is terribly addictive and we must do everything possible to support people who want to quit. Of course, people have the general right to smoke in their homes and gardens, in the street, in the park and elsewhere. However, as Donald Gorrie rightly said, the right to smoke must cede to people's greater right to a smoke-free atmosphere in their workplace or in places of public entertainment.

Since the beginning of the Scottish Parliament, Liberal Democrats have pressed the cause of health promotion. The consultation is in the partnership agreement because of our contribution, and we were the first political party to back the ban. However, support for the ban goes right across the board and a series of contributions have been made by all sorts of people. The issue has developed a head of steam of its own, fuelled by public opinion, the New York and Irish experiences and particularly by Scotland's appalling health record. It is an idea whose time has come. Let us strike a blow for freedom to breathe clean air and—to ensure that we provide our young people with a future that is free of addiction—let us ensure that the bill passes stage 1.

Mary Scanlon (Conservative, Highlands and Islands)

It was interesting to hear the Minister for Health and Community Care welcome the bill and speak of the degree of urgency that he attaches to the legislation. I have to say that, when Kenny Gibson and Nicola Sturgeon introduced bills on the subject during the first session of Parliament, those bills were not welcomed and there was no rush to legislate.

I was also surprised that the Minister for Health and Community Care allocated only two minutes of his speech to measures in the bill other than those that relate to smoking. I hope that, throughout the next stages of the bill, a bit more time will be allocated to those important measures.

Andy Kerr (Labour, East Kilbride)

I accept fully Mary Scanlon's point. However, in the interests of the debate, I took a number of interventions during my speech. Indeed, I accepted every intervention that was made.

Mary Scanlon (Conservative, Highlands and Islands)

Fair do's. We will see how the minister performs at later dates.

I would like to pay tribute to Duncan McNeil, who made an excellent and balanced speech.

Members who are not on the committee that has dealt with a bill are always at a disadvantage in stage 1 debates, because committee members have heard all the relevant evidence. However, I read the Health Committee's stage 1 report on the bill and I would hardly say that it is a ringing endorsement of the bill, or that it expresses much confidence about the success of the measures that are proposed. For example, the committee states that free oral health assessments and eye examinations have the potential to improve standards "if properly implemented". On dental services, the committee states that the policy could work

"if properly funded and implemented".

On pharmaceutical care services, the committee again states that the measures could ensure a wider range of services "if properly implemented". That is hardly a ring of confidence.

It is interesting that the voices on the Conservative benches are speaking in support of the late Donald Dewar who, when he was in Westminster, worked with the industry and responded to consumer and health needs by introducing the voluntary code for better signage, better ventilation, smoke-free areas and other measures that provide choice for consumers.

We want to work with the licensed trade sector to enhance choice for smokers and to provide practical help, support and encouragement to people who want to stop smoking, with the ultimate goal being—as Dr Nanette Milne said—of achieving a smoke-free environment for everyone. I welcome the measures and the increased resources to assist people to stop about which the minister spoke.

Sylvia Jackson constantly talks about the BMA. If she looked back to the BMA's stance on—

Helen Eadie (Labour, Dunfermline East)

Does Mary Scanlon accept that when the licensed trade sector was given the opportunity to operate voluntarily as she described, there were major problems? Although targets were met, the number of people who participated in the voluntary scheme was so small that it was not worthwhile, which is why legislation was needed.

Mary Scanlon (Conservative, Highlands and Islands)

From memory, I can tell Helen Eadie that something like £132 million was spent in one year on ventilation alone. I do not accept the view that the licensed trade was not co-operative. According to a poll in January this year, 75 per cent of Scots believe that smokers have the right to smoke in public, provided that they do not inconvenience non-smokers.

I regularly visit Donegal, as does Jamie Stone, and I can say that the licensed trade industry has been affected by the smoking ban. Many publicans have tried to increase food sales, but many others have at the back of the pub built the equivalent of bus shelters, which have three walls and one side open to the area and which serve as the smoking areas. The ban is hardly stopping smoking in Ireland.

At the heart of the bill is the effect of smoking on the health of smokers and the effect of passive smoking on the health of non-smokers.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

Will the member take an intervention?

Mary Scanlon (Conservative, Highlands and Islands)

Certainly not from Mike Rumbles—no way on earth would I take an intervention from him. We have heard enough of his—oh; there are no words for what we heard from him today.

There are many measures, short of the draconian ban on smoking in public places, that can help people to stop smoking. If the aim is to stop people smoking, surely it is better to try tested methods that are known to bring success rather than to risk making more people smoke in their homes, where young children are present.

Tricia Marwick (Scottish National Party, Mid Scotland and Fife)

Will the member give way?

Mary Scanlon (Conservative, Highlands and Islands)

I am sorry, I have only one minute left and I have quite a lot of ground to cover.

I think that we dealt last week with dental checks. However, given that £7.7 million is being allocated for free dental checks and that the minimum cost for a dental check, at least in the Highlands, is £25, that means that only 308,000 people could get a dental check.

We constantly forget about chiropody and podiatry. Recently, the father of a 12-year-old footballer came to me and said, "If he is to keep playing football, my son needs an orthotic fitment costing more than £200. I can pay for that, but many others can't." If the Executive is going to be generous in relation to eye and dental care, it should re-examine the needs of podiatry and chiropody, because much has to be done in that regard.

I would like to have said more about the disciplinary provisions in the bill. It is surely an error that no reference is made in the relevant section to the General Medical Council. General practitioners raised concerns during the passage of the Adults with Incapacity (Scotland) Bill but were ignored. I am glad that the situation is being rectified in this bill.

Brian Adam (Scottish National Party, Aberdeen North)

Today is a great day. We are about to pass one of the most far-reaching measures that we could ever pass to improve public health in Scotland, and it is a great privilege to be associated with it. I give credit to the many people who have brought us to this point, particularly people outside Parliament who have campaigned long and hard for the measure, but also members in the current and previous sessions of Parliament. I acknowledge the efforts that were made by my colleague Kenny Gibson—who is no longer in Parliament—in introducing his bill. I also acknowledge the efforts of Stewart Maxwell, who introduced a bill on smoking in the current session, and Nicola Sturgeon, who introduced a bill on tobacco advertising controls.

It is not just SNP members who have done work on the matter; Irene Oldfather is convener of the cross-party group on tobacco control. She was preceded by myself and Kenny Gibson. The cross-party group, which even includes Conservatives, has striven to improve the situation. I also pay tribute to the previous Deputy Minister for Health and Community Care, Tom McCabe, for the sterling work that he did in bringing us to this point. Mr McCabe conducted the Executive's consultation exercise superbly; the measure of that is that people participated in it. As convener of the Standards Committee, I was perhaps a little disappointed that we received only a few more than 30 responses to our consultation, just over 20 of which were from members of the public. In contrast, 54,000 responses were received on the smoking ban. It is a measure of the success of Parliament and its procedures that we have engaged with the public on the matter, and it is clear that we are delivering what the public wants.

It is right for us to debate the matter. I am pleased that the Conservatives are contributing to the debate, although I do not agree with the position that they take. I found the point that was made by Phil Gallie rather odd—I hope that the Tories do not advocate increased tobacco use for weight control. I am sure that that is not the case, but that was, nevertheless, the implication of what Phil Gallie said.

Brian Monteith (Conservative, Mid Scotland and Fife)

Will the member take an intervention?

Brian Adam (Scottish National Party, Aberdeen North)

If the member will let me develop the point, I will let him in after that.

It is not surprising that the Tories look to market forces to deliver the change, but they slavishly follow the line of industry interests rather than that of the health service.

Brian Monteith (Conservative, Mid Scotland and Fife)

The member is sailing close to the wind with the idea that Phil Gallie, who is not here to defend himself, suggested that tobacco use should be increased to fight obesity. His point was that there could be unintended consequences that would not be popular in respect of public health. I would have thought that Brian Adam would support that view.

Brian Adam (Scottish National Party, Aberdeen North)

We should always be aware of unintended consequences, but the unintended consequence of the market-led approach is that nothing happens. The voluntary code to which Mary Scanlon referred—which was introduced, I believe, in 1998—was not working. That is why we have got to this point: the voluntary approach did not work. The industry did not deliver, and ventilation did not deliver; there is clear evidence to suggest that the key carcinogens are not removed by ventilation.

At the risk of being accused of misquoting Mr Monteith, just as I was accused of misinterpreting what Phil Gallie said, I understand that Mr Monteith concedes that environmental tobacco smoke is dangerous. He does not suggest—I have not heard any of the Conservatives suggest it—that it is not dangerous. We should to take action against it. That is why we should go ahead with the ban, which is the principal measure in the bill. The softly-softly-catchy-monkey approach, which suggests that we should move at the pace at which the industry wants to move, will not deliver. Market forces do not deliver on everything and they will certainly not deliver on smoking. Public action is required for public health protection, which is why I support the bill.

Elaine Smith (Labour, Coatbridge and Chryston)

On the slightly different issue of public services, I have concerns about joint ventures, as does the Health Committee. What is Brian Adam's opinion on the amendment in the name of Carolyn Leckie? Does he think that it is rather sweeping, in that it says that

"section 31 of the Bill compromises the general benefits to health from the Bill"?

I have not heard much about the amendment this morning.

Brian Adam (Scottish National Party, Aberdeen North)

There is merit in considering closely the point that is made by the mover of the amendment. It raises an important issue and I suspect that we may have some sympathy with it, but I hope that we will not be distracted by it on what is a significant day for public health.

Murray Tosh (Conservative, West of Scotland)

One minute.

Brian Adam (Scottish National Party, Aberdeen North)

As well as the mortality effects of environmental tobacco smoke, we should consider its morbidity effects. It damages people's health: people do not die immediately as a consequence of inhaling someone else's smoke, but environmental tobacco smoke creeps up on people gradually. It has an impact on their hearts and lungs and they might end up with lung cancer or coronary heart disease. It is a significant additional risk factor in both those diseases. It has an impact on people's health over a long period of time and it also has unpleasant side effects, such as the smell. That, in itself, would be enough to encourage us to deal with it, but it also has effects on morbidity and mortality.

We need to be careful about how we enforce the ban. The best enforcement will be by the public themselves, through general acceptance and by persuasion. Duncan McNeil argued along those lines and that is the view of the Health Committee.

Murray Tosh (Conservative, West of Scotland)

You must close now.

Brian Adam (Scottish National Party, Aberdeen North)

I noticed that members of the Health Committee nodded their heads in response to earlier comments on that point. I am—

Murray Tosh (Conservative, West of Scotland)

You must close now.

Brian Adam (Scottish National Party, Aberdeen North)

I am just about to do so.

Murray Tosh (Conservative, West of Scotland)

No—now.

Brian Adam (Scottish National Party, Aberdeen North)

I am delighted to support the bill today.

Murray Tosh (Conservative, West of Scotland)

I now call the minister. You have a very strict 10 minutes.

Rhona Brankin (Labour, Midlothian)

I echo what other members have said: this is an historic day for our Parliament. I, too, pay tribute to all the people who have worked so hard to bring the bill about. I notice that Tom McCabe is with us; I pay tribute to the work that he has done.

The Smoking, Health and Social Care (Scotland) Bill will deliver some of the most important public health measures for a generation. The introduction of free eye and dental examinations will bring significant benefits in the early detection of eye and oral disease and will support further development of ophthalmic and dental services. The role of community pharmacists will be secured and extended to ensure that they play a significant role in delivery of primary health care. The NHS disciplinary system will be strengthened to ensure that protection of patients remains paramount. The bill makes provision to capture in legislation a scheme for ex gratia payments to certain persons who contracted hepatitis C as a result of NHS treatment.

For the first time, Scottish ministers will have the power to enable health boards to enter into joint ventures. That will allow health boards greater choice in how they deliver health care facilities and services to the people of Scotland, by allowing them to take a strategic approach to provision of health care facilities in the community.

Carolyn Leckie (SSP, Central Scotland)

Will the member take an intervention?

Rhona Brankin (Labour, Midlothian)

I will address later in my speech some of the points that Ms Leckie made.

The bill will also provide an opportunity to tap into Scottish scientific and technical genius by making the most of intellectual property for the benefit of NHS Scotland.

I turn to the provisions on smoking. The bill is not about banning tobacco; it is about protecting people's health. There is overwhelming evidence that demonstrates the harm that environmental tobacco smoke does to people and their families. Smoking is also a major factor in health inequalities. We need to act now and must not shy away from making unpopular decisions so that we can deliver health improvements for Scotland, which is why the key measure of the bill is the prohibition of smoking in certain enclosed places.

The bill aims to improve the health of the nation and to increase the choice that is available to the vast majority of the people of Scotland, who do not smoke. It aims to offer freedom to enjoy the pleasures of life, whether going out for a drink or a meal, pursuing a pastime or simply shopping in a smoke-free atmosphere. In short, the bill offers a healthier way of living, in which smoking is not the norm and young people know that they do not have to follow the bad habits of past generations or suffer the appalling consequences.

I will respond to some of the points that members made. I say to Carolyn Leckie that involving the private sector is nothing new. Some 50 per cent of general practitioner premises are already privately owned. The Scottish Trades Union Congress protocol with Scottish ministers and the guidance on it clearly indicate that the protocol applies to all public-private partnerships. Public-private joint ventures are a form of PPP, so the protocol would apply in such cases.

Carolyn Leckie (SSP, Central Scotland)

Will the minister give way?

Rhona Brankin (Labour, Midlothian)

No, thank you. I want to address many points and I have already referred to what Carolyn Leckie said.

Several members mentioned the Office of Tobacco Control in Ireland. It is important that enforcement be carried out as effectively as possible and we are developing an effective network throughout Scotland to ensure effective implementation. However, our minds are not closed on the matter.

Delivery of free dental checks for all will be challenging, but we are convinced that the measures in the dental action plan will help us to meet that challenge. Indeed, the extended oral health assessment that is being discussed as part of the modernising dentistry process is not a specific deliverable of the bill. The extended eye examination is also subject to discussions as part of the ophthalmic services review—again, such examinations are not a specific deliverable of the bill.

On screening of schoolchildren, we already have provision for dental inspection and education for all school pupils. The inspection programme targets primary 1 and primary 7 children and the huge investment in children's oral health that we recently announced will immeasurably strengthen provision on the ground.

On eye screening for children, the "Health For All Children: Guidance on Implementation in Scotland" draft consultation, which was issued to all health boards earlier this month, states:

"All children should be screened by an orthoptist in their pre-school year, between the ages of four and five years"

and adds that

"The evidence for screening in secondary school remains inconclusive."

However, it is made clear that any child who undergoes assessment for educational underachievement or other school problems should have a visual test. We will continue to consider that issue before stage 2.

Ministers have great sympathy for the relatives and dependants of people who died before the eligibility date of the hepatitis C scheme, but we must consider the effects of financial outlay on the scheme on our ability to provide treatment for other patients. For that reason, the scheme focuses on people who are currently suffering. We are considering with other United Kingdom Administrations the issue of overseas residence and may lodge an amendment in the light of those discussions.

At the moment, we are not minded to exempt day care centres and I note what has been said about the bill's being potentially opened up. We believe that people who spend time in day care centres who do not smoke also deserve to be protected.

Stewart Maxwell talked about the definition of smoking. Our minds are still open about the definition and we will continue the dialogue before stage 2. Sylvia Jackson talked about the Subordinate Legislation Committee. I confirm that ministers received a letter from that committee yesterday and that we are considering it.

I would like to quote comments by schoolchildren to the Health Committee about the effects of smoking. One said:

"people should not have to breathe in other people's smoke when they go into a pub or restaurant."

Another said:

"It has been proved that Scotland has one of the worst rates of coronary heart disease, which can be caused by smoking."—[Official Report, Health Committee, 15 June 2004; c 1014.]

Another child said:

"It is not fair that we are getting cancers and diseases because other people have chosen to smoke!"

and another said that

"the future is pretty bleak unless we do something right now."

Finally, one child said:

"For Scotland's sake let's stop people smoking in regulated areas."

This will be the most important legislation on public health for a generation. Members have an opportunity to endorse principles that will bring benefits for generations of Scots to come. We must seize this opportunity for the sake of future generations—for the sake of the young schoolchildren who wrote to the Health Committee and those who have talked to the First Minister about their health and that of their future families. The opportunity is too important to miss for the future health of the people of Scotland. I urge members to support the motion and to reject Carolyn Leckie's amendment.

Stewart Maxwell (Scottish National Party, West of Scotland)

On a point of order, Presiding Officer. Will you investigate a situation that has occurred in respect of the public galleries? Last night at a reception with the First Minister, a number of organisations and individuals who were interested in the debate on the Smoking, Health and Social Care (Scotland) Bill approached me and said that they had tried to get tickets for it, but had been told that the galleries would be full and that no tickets were available. However, the galleries have been virtually empty this morning. Will you investigate that matter?

George Reid (None, Ochil)

I will do so and I will write to you.

Question Time — SCOTTISH EXECUTIVE — General Questions

Christine May (Labour, Central Fife)

To ask the Scottish Executive how the new deal is helping young people in Fife into secure employment. (S2O-6523)

Allan Wilson (Labour, Cunninghame North)

Employment policy is reserved to the United Kingdom Government, which takes the lead on funding and delivery of the new deal. The new deal for young people is delivered by Jobcentre Plus and provides training, education, work experience and job-search support to help long-term unemployed young people to move into sustained employment. Since the new deal for young people began, 5,190 young people in Fife have gone into jobs and 78 per cent of those job outcomes were sustained.

Christine May (Labour, Central Fife)

The minister may be aware of figures that were released yesterday showing that the financial services sector has grown by 6.4 per cent. Many clients who have been recipients of new deal support in my constituency have found jobs in the financial services sector. Will he outline what he fears would result from any diminution of the new deal or from its being stopped?

Allan Wilson (Labour, Cunninghame North)

Indeed. Youth unemployment is down 79 per cent since January 1997 and down 57 per cent since January 1999. Such reductions are due in no small part to the impact of the new deal. The member refers to the financial services sector, which we debated only yesterday. Like other sectors, that sector makes an important contribution to the growth of the economy, which of course provides the job opportunities that have been taken up by those young people.

Murdo Fraser (Conservative, Mid Scotland and Fife)

Given that the Government's figures show that barely a third of people who go into the new deal programme find jobs that last more than 13 weeks, is it not time to stop the appalling waste of money and use it to reduce taxation on our overburdened businesses? Of course, that is not only the Conservatives' policy but the policy of the Liberal Democrat Minister for Enterprise and Lifelong Learning.

Allan Wilson (Labour, Cunninghame North)

Doing so would consign those young people to the dole. Young people were familiar with being consigned to the dole during the Tory years and I suspect that the people of Scotland and the United Kingdom do not wish to return to that. Therefore, I do not see any prospect of a Tory Government being in a position to scrap the new deal.

John Home Robertson (Labour, East Lothian)

To ask the Scottish Executive what action is being taken to reduce unemployment in East Lothian. (S2O-6514)

Jim Wallace (Liberal Democrat, Orkney Islands)

Scottish Enterprise is charged with pursuing the strategic priorities for economic development that are contained in the Executive's "A Smart, Successful Scotland" enterprise strategy. Those priorities include improving productivity and competitiveness to enhance the long-term growth rate of the Scottish economy—including in East Lothian—to generate greater prosperity and employment and to reduce economic inactivity.

John Home Robertson (Labour, East Lothian)

Does the minister acknowledge that the record low unemployment rate of 2.3 per cent debunks Mr Michael Howard's assertion that the minimum wage would cost jobs? I remind the minister that more than 3,000 of my constituents were out of work when Mr Howard was last in the Cabinet back in the 1990s. On what Murdo Fraser said, is it too much to ask a Liberal Democrat to acknowledge that Gordon Brown's new deal has been a spectacular success that will help to get even more people back into work in East Lothian and elsewhere?

Jim Wallace (Liberal Democrat, Orkney Islands)

I am only too pleased to confirm the figures and the picture that John Home Robertson has given about low levels of unemployment in East Lothian. East Lothian has a claimant unemployment rate of 2 per cent, which is significantly down from when Mr Howard was last in the Cabinet, as John Home Robertson said. Scotland's employment rate of 75 per cent is higher than that in any other part of the United Kingdom and higher than that in any other European Union country other than Denmark. East Lothian's employment rate is even better, at 79 per cent. I am always prepared to give credit where it is due, not least to the Chancellor of the Exchequer, Gordon Brown. Much of his economic success has been underpinned by the operational independence of the Bank of England, a policy on which I campaigned during the 1997 election and I am sure that Mr Home Robertson, in the same spirit, will give us credit for that.

Nanette Milne (Conservative, North East Scotland)

To ask the Scottish Executive what discussions it has had with local authorities regarding sheltered housing tenants' concerns about the financial burden of supporting people charges. (S2O-6492)

Johann Lamont (Labour, Glasgow Pollok)

We are aware of concerns about the supporting people programme charges, but it is for councils to determine charges in line with the Convention of Scottish Local Authorities guidance. COSLA is consulting local authorities on revised guidance and we are in discussion with COSLA about that.

Nanette Milne (Conservative, North East Scotland)

I thank the minister for her answer on an issue that is causing concern among pensioners in Scotland. I ask her to respond to the concerns of one of my constituents, Mr Henderson, who is a pensioner from Oldmeldrum in Aberdeenshire and who, with his wife, faces an additional £62 per month charge under the supporting people programme on top of his rent, council tax and warden charges. He is now so concerned about the additional burden that he is planning to move out of sheltered housing.

Johann Lamont (Labour, Glasgow Pollok)

In any particular case, it is always helpful if the constituent writes to me with the details so that I can give the member a full and accurate response and so that I can make sure that the individual's particular circumstances can be covered.

There should not be extra charges without the agreement of the person involved. The extra charges should relate only to inflation or to changes in services. We are closely monitoring the situation, along with COSLA. We should not forget the huge budget of the supporting people programme. An investment of £1.2 billion over three years is a significant level of funding to support some of the most vulnerable people in our communities.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

I am rather surprised to hear the minister suggest that the charges are voluntary. I have written to the minister and her predecessor on six occasions in response to an approach from a constituent. How can explain the fact that people in Aberdeenshire have a different regime from that in Aberdeen, which is different again from that in Dundee? How do we tell people that we are denying them services because we are introducing a charge? That is simply not acceptable.

Johann Lamont (Labour, Glasgow Pollok)

The member misunderstands. There is a change in the way in which charges are made for the payment of rent to the landlord and for the provision of services. It is an important point because, for example, it allows voluntary sector providers to tender for work. The member knows as well as I do that the quality of the work that is done by voluntary organisations that have expertise in dealing with vulnerable groups is crucial, and we want to harness that. It is also important to understand our commitment to local decision making. We expect there to be differences in different parts of the country, given the different local authorities' priorities. We are also committed to harmonising the policy throughout Scotland and we will be considering it closely along with COSLA.

Kate Maclean (Labour, Dundee West)

To ask the Scottish Executive what new action it will take in light of the increase in violent attacks on firefighters in Tayside in the last six months. (S2O-6520)

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

Assaults on firefighters and other emergency workers are completely unacceptable. We have taken action through the Emergency Workers (Scotland) Act 2005 and the Fire (Scotland) Act 2005 to increase the penalties for people who are convicted of such assaults. We will continue to work closely with the fire and rescue service and other agencies to ensure that fire crews are given as much protection as possible.

Kate Maclean (Labour, Dundee West)

Is the minister aware that there have been six attacks on firefighters in Dundee in the past six months? That compares with the one or two attacks in the same period in the previous year. Is she aware that there is under-reporting of attacks on firefighters and that what could be regarded as relatively minor attacks go unreported? Has the Scottish Executive given any thought to a national strategy to deal with the issue?

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

I am aware that the Fire Brigades Union has suggested that it would like a national strategy to deal with the issue. We have to take a co-ordinated approach across the public sector to try to ensure that we get protection for workers.

I would be concerned if there was under-reporting and I encourage people to report such incidents. In Scotland in 2003-04, 222 physical attacks on fire service personnel were reported, along with 166 instances of verbal or other abuse and interference with equipment. In Tayside, there were six reported incidents involving firefighters in the year to the end of March 2005, compared with 16 in the previous year. Of the six incidents, three involved physical attacks on staff, two involved verbal abuse and the other one was an unconfirmed report of a missile being thrown at a fire crew. That is unacceptable. A secondee from the Scottish Trades Union Congress has been working with the Executive on implementing our initiatives aimed at preventing violence against any worker who is involved in the public sector.

Shona Robison (Scottish National Party, Dundee East)

Is the minister aware of the concerns that the FBU raised about the impact on the safety of firefighters and the public if the number of fire control rooms is reduced, including in Tayside? Can she confirm whether that decision has already been made, given that the Executive included the reduction in its savings that were published on 31 March? If so, would that be a breach of parliamentary trust, given that we were assured that the decision would come back to the Parliament?

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

The member will have heard my deputy, Hugh Henry, say on a number of occasions that further information was required following the initial consultation on fire control rooms. That work was done. Ministers are considering it and no final decision has been taken. It will be made known to Parliament in the correct way in due course.

Bill Aitken (Conservative, Glasgow)

Does the minister agree that, in light of the Parliament's unanimous condemnation of the behaviour in question, the appropriate way of prosecuting all cases of it would be on indictment? Will she discuss that with her colleague the Lord Advocate?

Cathy Jamieson (Labour, Carrick, Cumnock and Doon Valley)

The member will want to know that the Lord Advocate has reissued his guidelines to try to ensure that people are aware of the seriousness with which such incidents are viewed. It is not for me to decide whether it would be appropriate for them all to be dealt with on indictment. There might be some instances where that would not be appropriate. However, I assure the chamber that the Executive takes any assault very seriously. Assaults on public sector workers such as emergency crews going about their business are completely unacceptable and must end.

Rob Gibson (Scottish National Party, Highlands and Islands)

To ask the Scottish Executive whether it has a national strategic rail development plan for Scotland over and above the local initiatives in the partnership agreement. (S2O-6498)

Nicol Stephen (Liberal Democrat, Aberdeen South)

Scottish ministers will develop a rail strategy for Scotland, as part of a national transport strategy, during the coming year.

Rob Gibson (Scottish National Party, Highlands and Islands)

As strategic cross-Scotland rail lines such as Perth to Inverness, Inverness to Thurso and Wick, and Aberdeen to Inverness can shrink distance poverty, does the minister agree with me and the Amicus union branch in Thurso that the time has come for a full and proper investigation into the benefits that the far north line brings to the Highlands and Orkney? What investment is required to provide the north with a modern rail service that meets the aspirations of travellers and the Scottish Executive?

Nicol Stephen (Liberal Democrat, Aberdeen South)

As part of the development of the national rail strategy, we have, with the Strategic Rail Authority, commissioned a Scottish rail planning assessment. Ove Arup & Partners Scotland Ltd has been appointed as consultant for that work. It is considering future demand for the network and where the problems and further opportunities are that go beyond our current ambitious proposals for development of the network. I urge any MSP who has thoughts, ideas or proposals about this to contact me. That applies to the far north line and to rail improvements in all parts of Scotland. I will ensure that all proposals are fed into the development of the national strategy.

Jeremy Purvis (Liberal Democrat, Tweeddale, Ettrick and Lauderdale)

In light of the 2005 Scottish National Party manifesto proposals for a £5 billion bullet train and the lack of any commitment in the 2003 SNP manifesto for the Borders rail project, will the minister assure me that he will not follow any local or national rail plans of the SNP as the Executive develops its strategy?

Nicol Stephen (Liberal Democrat, Aberdeen South)

It is important that those MSPs who are making proposals for the national strategy should feel confident that the proposals are supported by their party as well as being likely to get the Executive's support. It is important that we focus our future investment on the right proposals. I am sure that it will be for us all to ensure that when the 2007 election comes around we all put forward properly costed, affordable and deliverable policies—the sort of policies that the Executive partnership is currently putting forward with improvements such as the Airdrie to Bathgate line, the Stirling-Alloa-Kincardine line, the Larkhall to Milngavie line and the Borders rail link.

Mark Ruskell (Green, Mid Scotland and Fife)

One of the frustrations for communities such as Blackford, where people desperately want a rail station to be reopened, concerns not only the lack of funding that is available for such reopenings, because of the Executive's road building programme, but the lack of clarity about what future demands on local rail routes from long-distance rail routes might be. When will we have a clear picture of the balance that needs to be struck between long-distance and short-distance rail services and of where station reopenings fit into that?

Nicol Stephen (Liberal Democrat, Aberdeen South)

I have explained that we are developing a national rail strategy for the first time. That work is on-going. We are considering new proposals and are looking to develop the rail network. One would think that the current situation for rail was static or that we were slipping backwards, but the reverse is the case; we are now investing more in public transport than ever before. We are increasing the level of funding so that 70 per cent of our expenditure will be on public transport and the balance will go on our roads. That is a big boost for public transport. I will not repeat all the public transport projects and all the rail projects in which we are investing, but they are significant and run into hundreds of millions of pounds of investment. These are exciting times for the rail industry in Scotland and we are attracting new rail staff to work for the new national transport agency on those exciting rail developments. We will ensure that we have the widest possible consultation about future developments. The Executive is committed to providing better rail services in Scotland, which is one reason why we saw an increase in rail passenger numbers of 11 per cent over the past 12 months.

Irene Oldfather (Labour, Cunninghame South)

To ask the Scottish Executive what action it is taking to promote participation in Europe day. (S2O-6534)

Tom McCabe (Labour, Hamilton South)

Europe day is the day when we celebrate the unity of the peoples of the European Union and we have been doing so since 1985. The Scottish Executive, together with the Scottish Parliament, the European Commission and members of the European Parliament in Scotland, will host a reception in the Parliament on the evening of 9 May to mark Europe day as part of further promotion of the benefits of the European Union.

Irene Oldfather (Labour, Cunninghame South)

Does the minister agree that the vision that Robert Schuman had of a peaceful and prosperous Europe is more relevant today than ever and will the minister join me in congratulating local authorities throughout Scotland, including North Ayrshire Council, on the work that they do not just on Europe day but throughout the year to encourage educational exchanges that enable young people throughout Scotland to experience directly the benefits of being part of the new Europe?

Tom McCabe (Labour, Hamilton South)

I am more than happy to endorse those sentiments and the sentiments contained in the motion that the member lodged recently.

Richard Lochhead (Scottish National Party, North East Scotland)

What steps is the Executive taking to ensure that Scotland and the Parliament can participate in Europe, and not just Europe day? As the minister will be aware, the Government failed on most of its objectives in negotiating the European constitution. What new steps are going to be taken to ensure that the people of Scotland and the Parliament can directly influence decisions that are made in Europe that affect our everyday lives?

Tom McCabe (Labour, Hamilton South)

One of the things that we will not be doing is encouraging people to vote against the new constitution. We will do the same as we have always done and promote the benefits of the European Union, such as the peace, prosperity and employment and social changes that it has brought. We will continue to do that today and every day in the future.

Phil Gallie (Conservative, South of Scotland)

Does the minister agree that an excellent way of promoting Europe day would be to remove the uncertainties surrounding the EU? On that basis, will he press for an early referendum? In the wish for European solidarity, will he join me in hoping for sound judgment from the French people at the end of next month?

Tom McCabe (Labour, Hamilton South)

An excellent way of promoting the benefits of the European Union would be for Mr Gallie to drop his ideological blinkers and acknowledge the benefits that it has brought the people of Scotland for many years.

George Reid (None, Ochil)

Before we come to First Minister's questions, members will wish to welcome in this G8 year officials of the Red Cross societies of Europe and their United Nations representative, Encho Gospodinov. [ Applause. ]

First Minister's Question Time

Nicola Sturgeon (Scottish National Party, Glasgow)

To ask the First Minister what issues will be discussed at the next meeting of the Scottish Executive's Cabinet. (S2F-1597)

Jack McConnell (Labour, Motherwell and Wishaw)

The Cabinet will meet briefly next Wednesday and discuss issues of importance.

Nicola Sturgeon (Scottish National Party, Glasgow)

On 20 March 2003, the First Minister praised the United Kingdom Government for being the first Government "in living memory" to

"put the possibility of going to war to a vote in the House of Commons".—[Official Report, 20 March 2003; c 19800.]

Does the First Minister agree that MPs should have been made aware of the grave doubts that we now know the Attorney General had about the legality of the war in Iraq before they were asked to vote to send our servicemen and servicewomen to war?

George Reid (None, Ochil)

I make it clear at this point that the First Minister is responsible for what he says in Parliament and in the country, but not for what others say elsewhere.

Pauline McNeill (Labour, Glasgow Kelvin)

On a point of order, Presiding Officer. If you allow this question to be debated at First Minister's question time, I insist that you allow the same latitude to back benchers.

George Reid (None, Ochil)

I made it clear that the First Minister is responsible for what he says in the chamber and for what he says in the country. He is not responsible for advice given by the Attorney General to Government at UK level. The question is, therefore, to Mr McConnell.

Jack McConnell (Labour, Motherwell and Wishaw)

I am not responsible for that advice, but I am happy to refer to the fact that that advice was published this morning. Ms Sturgeon will see from what was published that what she claims is, in fact, wrong. I said at that time—and I absolutely adhere to that position today—that it was right and proper for this British Government to be the first ever to put a decision to go to war to a vote in Parliament and to secure the support of the British Parliament for that decision. I have absolutely no doubt that that was a tough decision for the Prime Minister to take and that that difficult decision was not made lightly. I also have absolutely no doubt that members of Parliament from all parties, when they voted on that decision in the House of Commons, voted having given it due consideration. Ultimately, I believe that they made the right decision.

Nicola Sturgeon (Scottish National Party, Glasgow)

I make it clear that my line of questioning is entirely based on comments made by the First Minister in this chamber. This is a question of whether the UK Parliament, the Scottish Parliament and the public were given the facts about the reasons for, and the legality of, the war in Iraq.

On 13 March 2003, the First Minister left us in no doubt that he thought that United Nations resolution 1441 provided, if necessary, a legal basis for war. He said that there was

"no doubt that it was a serious and final declaration."—[Official Report, 13 March 2003; c 19435.]

Before he made that unequivocal statement to the Parliament and to the Scottish people, had the First Minister seen or asked to see any legal advice from the Attorney General to back it up?

Jack McConnell (Labour, Motherwell and Wishaw)

No, of course I had not, but I absolutely stand by that judgment. I quote for Ms Sturgeon what the Attorney General himself said last night, without even the additional information that we have this morning. The Attorney General said last night that what the document published yesterday does,

"as in any legal advice, is to go through the complicated arguments"

that led to his view. Far from showing that he

"reached the conclusion that to go to war would be unlawful,"

it shows how he

"took account of all the arguments"

before reaching any conclusions. That is exactly what any Government expects from its law officers. If Ms Sturgeon is claiming that the Government went to war on the basis of an untruth, or something that was hidden from the public, she is calling the Attorney General, not the Prime Minister, a liar. If she is calling the Attorney General a liar, that is a very serious accusation indeed to make of a law officer.

Nicola Sturgeon (Scottish National Party, Glasgow)

I was asking the First Minister about the legal basis for the comments that he made in this chamber on 13 March 2003. I asked him that question for a reason. We now know that the only legal advice that the Attorney General had issued at that time was issued on 7 March. On 7 March—just six days before the First Minister said that there was no doubt about resolution 1441—the Attorney General said that

"the language of resolution 1441 leaves the position unclear".

In other words, there was very real doubt. Does the First Minister not feel angry that he was not made aware of what, at that time, was the Attorney General's only legal advice and, as a result, was put in the position—albeit inadvertently—of misleading this Parliament?

George Lyon (Liberal Democrat, Argyll and Bute)

On a point of order, Presiding Officer.

George Reid (None, Ochil)

This is getting skewed for reasons that we all understand. I will take Mr Lyon's point of order.

George Lyon (Liberal Democrat, Argyll and Bute)

As the First Minister is responsible for the Executive's policy, how can he comment on events and issues that were decided at the Houses of Parliament in Westminster? Ms Sturgeon is straying far from the subject of what the First Minister said in this Parliament. Presiding Officer, it is time that you took action and ruled this out of order.

George Reid (None, Ochil)

As I have made clear before, the First Minister is responsible for what he says in Parliament and in the country. He is not responsible for advice that is given to the United Kingdom Government. I leave it to the First Minister to reply or not, at which point I might be moved to move on.

Carolyn Leckie (SSP, Central Scotland)

On a point of order, Presiding Officer. I think that we should have some consistency here, because it appears that your authority is being challenged. I have been chucked out for less. [ Interruption. ] I will repeat that, because members were laughing. I have been chucked out for less. What about George Lyon?

George Reid (None, Ochil)

Before we move on, I ask the First Minister whether he has anything to add.

Jack McConnell (Labour, Motherwell and Wishaw)

It is clear to everyone that Ms Sturgeon would rather debate matters from another place than debate the responsibilities that we have in this Parliament. It is critical that we ensure that the Parliament debates critical issues such as growing the Scottish economy, improving our health and education services and tackling crime.

However, I am also very happy to answer for what I say in this Parliament and elsewhere. I am clear that my opinion, which I genuinely held at the time, is one that I stand by today. I have known Iraqi civilians for more than 25 years and know that today they are freer, live in a more democratic society, are happier to return home and are pleased with the action that the British Government took. I stand with them now, just as I did then.

David McLetchie (Conservative, Edinburgh Pentlands)

To ask the First Minister when he will next meet the Prime Minister and what issues will be discussed between them. (S2F-1598)

Jack McConnell (Labour, Motherwell and Wishaw)

I look forward to meeting the Prime Minister of the United Kingdom after next Thursday's election, and will decide what I discuss with him when that meeting is arranged.

David McLetchie (Conservative, Edinburgh Pentlands)

I am sure that Mr Howard will be delighted to see the First Minister in the interests of co-operation with the UK's devolved legislatures and Executives.

However, on a matter for which the First Minister is undoubtedly responsible, will he tell us why, after eight years during which waiting lists and times in our national health service in Scotland have risen, hospital-acquired infections have multiplied and doctors have complained about being forced to work with outdated equipment, it takes a general election campaign to prompt the Minister for Health and Community Care to start talking about reforming our NHS by setting a national price list for operations and procedures?

Jack McConnell (Labour, Motherwell and Wishaw)

Never have so many untruths been spoken in one question from one member of this Parliament. It is simply not true that waiting times have gone up. As Mr McLetchie knows, when his party was in Government, the target for waiting times in the NHS was 18 months. Not only has that target come down to 18 weeks, but Scotland is increasingly ahead of the UK on in-patient waiting times, with people who used to wait more than nine or 12 months now waiting six months.

Not only do we have a stabilising and, I hope, given all the Minister for Health and Community Care's actions, falling level of MRSA in our hospitals, but we can at least measure these matters. The Conservatives did not properly measure out-patient waiting times or even the level of hospital-acquired infections. Mr McLetchie's claim that the health service in Scotland was in a better condition then than it is now is simply untrue. He knows that, and he cannot create a smokescreen by claiming that the Minister for Health and Community Care said something this week for the first time. In fact, the minister talked about a national price list in this chamber back in December. It was as clear as a bell. If Mr McLetchie reads the Official Report, he will see for himself that that is the case.

David McLetchie (Conservative, Edinburgh Pentlands)

The First Minister knows well that the statistics that we have been quoting in the Parliament for weeks were collected and put on record by ISD Scotland in 1997, just as they are in 2005. In that time, the median wait for an out-patient appointment in Scotland has gone up from 34 days to 56 days, which is an increase of more than three weeks. That is on the record and it is indisputable.

Let us not pretend that this week's comments by the Minister for Health and Community Care are anything other than a humiliating climbdown, which was no doubt brought about by the criticisms that the Prime Minister made. Let us consider the substance rather than the timing of the proposals, because that is the real issue. Mr Kerr said that a national tariff had been proposed as a means of comparing the cost of operations in different NHS hospitals and in the independent sector. That is what he said. If, as a result of that comparison, it turns out that patients in Scotland can be treated more quickly and for less in the independent sector, will the NHS under the First Minister's stewardship pay for that treatment or will that be vetoed by his Liberal Democrat allies in the Scottish Executive?

Jack McConnell (Labour, Motherwell and Wishaw)

We have made it perfectly clear that we already use the independent sector when it is appropriate to do so and that we will make greater use of it in the months and years to come. I know that in Dundee, Grampian, Glasgow and other parts of the country the Scottish National Party is opposed to such contracts and would rather that people waited longer, but the reality is that we already use the independent sector and that we will make more use of it in the months and years to come. The Minister for Health and Community Care made that clear in December; indeed, his predecessor had already made it clear some time before then.

The difference between that position, which is about ensuring that patients in Scotland are treated according to the principles of the national health service, and the position that Mr McLetchie is trying to hide from voters in Scotland during the current election campaign, is that he would take that money out of the NHS and use it to ensure that only those patients who could afford to pay for their operations—not those patients who most need operations, who have waited longest, who are in most pain or who, in the clinical judgment of the medical profession, need operations most quickly—would be subsidised to do so. The existence of that fundamental divide is precisely why I will not be meeting Mr Howard as Prime Minister after 5 May. The reason for that fundamental divide between the Executive and Mr McLetchie's party is that his party is interested only in subsiding those who can already afford to pay, whereas we will use health service resources according to health service principles to make a difference to those people who most need operations. We will use both the health service and the independent sector to do that.

David McLetchie (Conservative, Edinburgh Pentlands)

There is a fundamental lack of logic in the First Minister's answers. Why is it all right for the health service to use taxpayers' money to pay 100 per cent of the cost of an operation that is provided by the independent sector, but not all right for the health service to pay 50 per cent of that cost and to keep the other 50 per cent to treat patients who are still on the Executive's lengthy NHS waiting lists?

Jack McConnell (Labour, Motherwell and Wishaw)

Precisely because of the point that I have just made. I know that it is quite hard for a Tory to understand those basic principles because the Conservatives opposed the creation of the NHS. I can tell Mr McLetchie that the people of Scotland expect decisions in their NHS to be made on the basis of clinical need, the urgency of the case, the level of pain that a patient is in and their medical condition as assessed by medical professionals rather than on the basis of the size of their wallet, how much they are paid or how much they could contribute to their treatment. That is a fundamental divide.

We stand for a health service to which access is free at the point of need and determined on the basis of need; Mr McLetchie stands for one in which people can jump the queue because the state will subsidise them if they can already pay for their treatment. He is wrong.

Robin Harper (Green, Lothians)

To ask the First Minister when he will next meet the Secretary of State for Scotland and what issues he intends to discuss. (S2F-1614)

Jack McConnell (Labour, Motherwell and Wishaw)

Mr Harper will not be surprised to learn that I am in fairly regular contact with the Secretary of State for Scotland at the moment and that I expect to see him again over the next few days.

Robin Harper (Green, Lothians)

Last week, the report of Clive Fairweather and Charles Pelling on the Airborne Initiative (Scotland) was published. It identified Airborne as a success, in that it drew international interest and was the only strategy of its kind that helped high-tariff offenders not to reoffend. The evidence shows clearly that support for the Airborne Initiative should have continued. Does the First Minister agree that the decision to close Airborne was, at worst, a caving-in to nimbyism and misinformation and, at best, precipitate and unwise?

Jack McConnell (Labour, Motherwell and Wishaw)

No, I do not. Large parts of that report show just how little success the Airborne Initiative achieved. Scotland has the opportunity not only to deal with more of its young offenders, but to deal with them much more effectively and to ensure that fewer of those young people who were involved in persistent and dangerous offending, reoffend.

The decisions that we took then were right. Those decisions will lead to an improvement in tackling both offending and reoffending.

Robin Harper (Green, Lothians)

From 2000 onwards, the Airborne Initiative beat prison and probation. On every count, Airborne did better, including with regard to reconviction rates after release. In the last year of Airborne's operation, all of the changes recommended by two social work inspections that wanted to see Airborne succeed were instituted.

Despite repeated invitations to visit and see the improvements, the Minister for Justice and the Deputy Minister for Justice refused to see Airborne for themselves. Does the First Minister agree that this failure was at best an example of poor ministerial practice and at worst an example of a cavalier dereliction of ministerial duty that this chamber has a right to know will never happen again?

Jack McConnell (Labour, Motherwell and Wishaw)

I am surprised at the way in which Robin Harper raises these issues. His claims are outrageous and untrue. I will ask the Minister for Justice to write to him in some detail to refute the outrageous allegations that he has made about the work of the Minister for Justice and the Deputy Minister for Justice.

I reiterate that the Airborne Initiative needed to be replaced. It is being replaced by programmes that will treat more young offenders more appropriately and effectively, as part of the system. It will also build upon those elements of the Airborne Initiative that are worth retaining. Although we learn from the good parts, at the same time, we recognise when systems are not working and we replace them with systems that are more effective for more people in the longer term.

Karen Gillon (Labour, Clydesdale)

To ask the First Minister how improved access to broadband will help the Scottish economy. (S2F-1607)