Scottish Parliament, 2 February 2006

294 contributions from 72 members. The official report.

Official Report 2 February 2006

Business Motion

Trish Godman (Labour, West Renfrewshire)

Good morning. The first item of business is consideration of business motion S2M-3907, in the name of Ms Margaret Curran, on behalf of the Parliamentary Bureau, setting out a timetable for stage 3 consideration of the Human Tissue (Scotland) Bill.

Motion moved,

That the Parliament agrees that, during Stage 3 of the Human Tissue (Scotland) Bill, debate on groups of amendments shall, subject to Rule 9.8.4A, be brought to a conclusion by the time limit indicated (that time limit being calculated from when the Stage begins and excluding any periods when other business is under consideration or when the meeting of the Parliament is suspended, other than a suspension following the first division in the Stage being called, or otherwise not in progress):

Groups 1 and 2 - 40 minutes Groups 3 and 4 - 1 hour 10 minutes Groups 5 to 7 - 1 hour 40 minutes.—[Ms Margaret Curran.]

Motion agreed to.

Human Tissue (Scotland) Bill: Stage 3

Trish Godman (Labour, West Renfrewshire)

We move to stage 3 proceedings on the Human Tissue (Scotland) Bill.

I will make the usual announcement about the procedures that are to be followed. We will deal first with amendments to the bill, then we will debate the motion to pass the bill. For the amendments, members should have with them the bill as amended at stage 2—SP bill 42A—the marshalled list, which contains amendments that I have selected that were lodged by the deadline and the groupings that I have agreed.

The division bell will sound and proceedings will be suspended for five minutes before the first division this morning. The period of voting for the first division will be 30 seconds. Thereafter, I will allow one minute for the first division after a debate and all other divisions will last 30 seconds. As members are aware, the use of the division bell in stage 3 proceedings was agreed by the Parliamentary Bureau as part of the protocol on use of the division bell.

Trish Godman (Labour, West Renfrewshire)

Group 1 is on presumed consent of adults for transplantation. Amendment 11, in the name of John Farquhar Munro, is grouped with a number of amendments that are shown on the groupings list, which also shows the amendments that are subject to pre-emption. If members consult the list, that will save me from having to read them all out.

John Farquhar Munro (Liberal Democrat, Ross, Skye and Inverness West)

I hope that the debate will be useful and effective.

In the United Kingdom, on average one person who is waiting for an organ transplant dies every day. Between April 2004 and March 2005, 52 Scots who were awaiting transplants died. Many others did not even make it on to the list before they died. The many people who have family members or close relatives who are waiting for transplants know the trauma that that causes. In the past 10 years, although the number of people who are waiting for organs has increased, the number of organs that are available for donation has fallen. The resultant gap must be addressed.

The main reason why I have lodged amendments that promote presumed consent is that although I welcome the Scottish Executive's efforts to bridge the gap between organ donation and demand, its proposals alone will not increase the rate of organ donation, which presumed consent would do.

Figures show, and statistics demonstrate, that opt-out systems increase donation levels. Spain has the highest organ donation rate of any country: its opt-out system has led to a rate of 33 cadaveric organ donations per million population. The question is this: does Scotland aspire to reach that level or Denmark's level, which has less than half the number of donations per million population and which operates an opt-in system that is similar to that which the Scottish Executive proposes?

Repeated surveys indicate that 90 per cent of people in this country support organ donation, but only 21 per cent of people carry organ donation cards, which is surprising. Ninety per cent support the concept, but only 21 per cent carry cards to confirm their wishes. That indicates to me that, although the Scottish Executive's proposals will codify existing laws and perhaps make the work of transplant units easier, the core pool of people who wish to donate will remain limited to the 21 per cent of people who carry donor cards.

Unsurprisingly, when individual wishes are unknown and recently bereaved relatives are asked to decide whether to allow organ donation, many opt for the default position, which is not to donate. As a result, about 40 per cent of relatives refuse to give their consent. However, if they are asked the question again after a month, they say that the regret their decision.

Whatever the result of the votes on my amendments in the group, it is important that the Executive encourage people to discuss organ donation with their families. The adoption of a system of presumed consent would address that by making it easier for people to achieve their wish to donate, given the exceptionally high level of support for donation, and is therefore entirely in line with the principles of the bill. Also, the adoption of a system of presumed consent will increase the number of donations by the simple means of increasing the number of donors in the donor pool. Figures undoubtedly show a positive correlation between presumed consent and higher rates of organ donation. However, the stark fact remains that, even if we take the glowing example of Spain, only 33 bodies per million population there are suitable for donation.

At the very least, whatever the method of organ donation Scotland will have at the end of today, the Executive must at least aspire to a level of donation that is the same as, or greater than, that of Spain.

I move amendment 11.

Stewart Maxwell (Scottish National Party, West of Scotland)

John Farquhar Munro ably explained his reasons for lodging the amendments in the group and why it is vital that members support them. I, for one, support them.

The debate on amendment 11 and John Farquhar Munro's other amendments in the group is not about a small change to the law, a technical issue or an administrative change to an organisation; it is literally a debate on a subject that is a matter of life and death for many of our fellow Scots. As John said, 52 people died last year while they were waiting for transplant organs.

Recent estimates show that, if presumed consent were to be included in the bill, approximately 29 extra donations would be made. That figure does not mean that 29 people would be saved, but that 29 people would get a heart transplant, 29 more would get a liver transplant and another 58 would get kidney transplants. In total, 116 people would be saved if presumed consent were introduced. In addition to the 116 people who would be saved, another 58 people would be lifted out of blindness. We are talking not only about saving lives; many people need cornea transplants that will give them sight again.

The debate on John Farquhar Munro's amendments is extremely important. As he said, although 90 per cent of people in this country support organ transplantation, very few carry a card. I carry a card and I know that many other members of the Scottish Parliament also do, but many people do not.

Importantly, the debate is not about the removal of anyone's rights. If we were to have a system of presumed consent, a person would have the absolute right to say that they do not wish their body to be used after their death—that right is absolute; it cannot be taken away. Instead, we are talking about granting rights to people who are waiting desperately on transplant lists.

To this day I have never understood why other people should get the final say about what happens to me on my death. If I die and my expressed wish is that my body be used for transplant, why can others override my wish? I do not think that other people—whether my wife, mother, father, daughter or my nearest and dearest friends—should have the final say about what happens to me; I should have the final say. At the point of my death I want my body to be used, if it is at all possible, to help others. That is the right thing to do. By introducing presumed consent we could achieve that; we could give life to many people.

I urge members to look not to their party whips—I hope that they have not been whipped on this issue—but to their consciences, and to consider whether to introduce presumed consent would be the right thing to do for our fellow Scots. I ask members to support John Farquhar Munro's amendments.

Dennis Canavan (Independent, Falkirk West)

I support John Farquhar Munro's amendments for the simple reason that they would help to save lives. I am sure that we can all think of at least one friend or relative who has died waiting for an organ transplant that never came. Statistics suggest that every week someone in Scotland dies while waiting for a transplant and others die without even getting on to the waiting list. Nevertheless, many deceased persons' organs, which could have been used to save lives, are buried or cremated because the deceased person never got round to signing up to the organ donor register or to informing their relatives of their wishes.

It would be wrong to assume that all the people who are not on the register object to organ donation. Opinion polls suggest that about 90 per cent of the population would be willing to donate their organs for transplant, but only 21 per cent are on the register. If a system of presumed consent were to replace the status quo of presumed objection, there would be a greater likelihood of granting the wishes of deceased persons.

What about the wishes of the relatives? John Farquhar Munro's amendments would ensure that if the nearest relative objected and the deceased person had not opted in, the removal of organs for transplant could not go ahead. In such situations, the wishes of the relatives would be taken into account.

Evidence from other countries suggests that a system of presumed consent increases the rate of organ donation. Belgium and the Czech Republic have a system that is similar to what John Farquhar Munro proposes and they both have donation rates of more than 20 per million population, compared with only 12.3 per million population in the United Kingdom. That suggests that the amendments could lead to an increase of more than 60 per cent in the donation rate.

The Westminster Parliament failed to introduce a system of presumed consent in the Human Tissue Act 2004. The bill that is before us fails similarly, although public opinion is already moving towards support for presumed consent. A few years ago, there was only minority support for that position, but last year a survey that was conducted on behalf of the BBC indicated 60 per cent support.

Parliament has a great opportunity to show a lead not just to the people of Scotland but to people throughout the UK. By agreeing to the amendments, Parliament would lead public opinion, set an example to other parts of the UK and save lives, while respecting the wishes of people who have lost loved ones. I urge members to support the amendments.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

In introducing his amendments, John Farquhar Munro set out well why the bill is before us, which is to save lives by increasing organ donations. Last year, 52 people died because there were not enough organ donations and 700 people are still on the waiting list for donations.

In Scotland we are doing slightly better than the rest of the UK. Statistics that have just been published show that 21 per cent of people in the UK carry an organ donation card, as John Farquhar Munro and Stewart Maxwell said, but in Scotland the figure is nearer 25 per cent. The card is completely worthless, because it has no legal standing whatever. The card has no force in law, which is why the Executive introduced the bill; it wants to ensure that the card has legal effect. We had a little bit of to-doing at stage 2, but I am delighted that the Executive has ensured that the 25 per cent of Scots who carry cards and are on the register will have their wishes legally enforced as soon as the bill is passed.

Stewart Maxwell said that no one has the right to overrule his wishes. That is correct. The bill is all about authorisation, which the amendments fail to recognise. The whole basis of our national health service is informed consent, not presumed consent. In other words, it is not a case of doctor knows best or the state knows best.

I refer to some of the evidence that the Health Committee received; I wish that some members had turned up to listen to it. According to Dr MacKellar of the Scottish Council on Human Bioethics, the system of presumed consent, which John Farquhar Munro advocates, is supported only by the British Medical Association; none of the other medical organisations is in favour of it, because it would be a breach of the European convention on human rights and of bioethics. The argument that John Farquhar Munro, Stewart Maxwell, Dennis Canavan and others have made that an opt-out system would increase donations is wrong and flawed; it would not do so.

Stewart Maxwell (Scottish National Party, West of Scotland)

Will the member give way?

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

If the member waits a minute I will let him in.

In evidence to the Health Committee, John Forsythe of the Scottish Transplant Group said that a few years ago the refusal rate—the rate of relatives refusing consent to transplant—was 30 per cent and that it has now increased to 46 per cent. He said that we can only guess why the rate had risen, but following events at Alder Hey children's hospital, Bristol royal infirmary and other places, there has been a slight loss of trust of those who deliver care among those who receive it. It is important that what we put in place does not damage that trust further.

In paragraph 133 of the Health Committee's stage 1 report we highlighted John Forsythe's comments. We said:

"there is little evidence from international experience that changing to a presumed consent system produces a major change in levels of donation. He indicated that colleagues in Spain, where an opt-out system is used, had advised him that what happens there is very similar to what is proposed in the Bill - that relatives are consulted to ascertain the views of the deceased."

That is what the bill is about.

John Farquhar Munro's amendments are well-meaning—their aim is to increase the level of donations. However, I believe, and all the evidence suggests, that they would not do so. If the amendments are agreed to, they would damage the campaign, in which so many of us throughout the chamber and the country have been involved for so many years. They would increase mistrust of the NHS and the state and they are not supported by any medical organisation other than the BMA.

Authorisation, as is provided for in the bill, is the right way to proceed. I am convinced that, coupled with a major advertising campaign, the bill—unamended by John Farquhar Munro's amendments—will be instrumental in saving lives. It is a very good bill and the 700 people who are waiting for organ donations will welcome it. I do not think that the amendments would help in any way.

Trish Godman (Labour, West Renfrewshire)

Another three members wish to be called. They have two minutes each.

Nanette Milne (Conservative, North East Scotland)

I will be brief. The provision to ensure that once authorisation is in place relatives cannot overturn it after the death of the potential donor will strengthen the present opt-in system. It will, coupled with on-going promotion and support of transplantation, ensure an increased number of donors. None of us disagrees that we need more donors.

I point out to John Farquhar Munro and others who have cited the example of Spain that there, the most important factor in identifying donors is not considered to be the opt-out system but the fact that every hospital in Spain has someone with the responsibility for ensuring that, when a person dies, their relatives are approached with a view to the deceased's organs being donated. That is the significant factor, not whether we have an opt-in or an opt-out system.

Janis Hughes (Labour, Glasgow Rutherglen)

I am well aware of John Farquhar Munro's interest in this area, which is similar to mine and that of others, including my colleague, Margaret Jamieson, who has previously debated the matter in the chamber.

This is an emotive issue and I have much sympathy for the arguments that have been expressed. I believe that the bill, in the form in which it has been presented to Parliament, and the information that the Executive has committed to issue as part of the legislative process, will make a huge difference and will highlight the issues surrounding organ donation and transplantation.

I am aware of the systems in other countries, such as Spain, which John Farquhar Munro mentioned. There are various systems in various countries—I do not know which, if any, would be right for Scotland. There are soft opt-out systems and hard opt-out systems. Which would be right for Scotland? We have not had that debate. We did not take evidence on that at length during stage 1 of the bill, but such an important issue deserves careful consideration. We know that some people are in favour of what John Farquhar Munro suggests and that some people are not. We have to ensure that we hear everyone's views and that the professionals who are involved share the view of those who wish to change the legislative position.

We must give the matter careful consideration and we should not deal with it in amendments at stage 3. I hope that we can return to the matter at some point. I will not support John Farquhar Munro's amendments today.

Shona Robison (Scottish National Party, Dundee East)

The vote on the amendments should be a free vote, because it is not a party-political issue; it is about the views of individuals. My personal view is that authorisation is the way to proceed because we must respect the wishes of deceased persons. There should be informed consent, not presumed consent.

The relatives of a deceased person who had not expressed a view about organ donation will be consulted. Mike Rumbles made the most important point in the debate so far when he said that the issue is about trust. Like it or not, after Alder Hey and other tragedies, the public have lost some of their trust in the system. That must be built up again; the bill will go some way towards achieving that. It has the potential to increase the level of organ donation, but that potential will be realised only if the bill is backed up by an effective public information campaign about organ donation.

That will be the key to the bill's success. I ask people to support the bill and to reject John Farquhar Munro's amendments.

Lewis Macdonald (Labour, Aberdeen Central)

As many members have said, the most important principle in the bill is the principle of authorisation. We have put that principle in place because we recognise that the existing system of passive consent to organ donation is no longer fit for purpose.

In modernising our human tissue legislation, we had a choice to make between a system that would replace passive consent with active authorisation, which is what the bill proposes, or a system which would presume consent on the part of people who do not object, which is what John Farquhar Munro's amendments would put in place. As Janis Hughes suggested, a time might come when it will be safe to presume consent on the part of people who have expressed no view. However, that time is not now.

In my view, a change that is as radical as a switch to a system of presumed consent for transplantation could be introduced only if there were clear evidence of strong public and professional support for it. Although many members might welcome such a move, the evidence simply does not exist. As Mike Rumbles, Nanette Milne and others said, one of the lessons from disclosures about retention of children's organs after post-mortem examination is that, for many people, presumed consent is not consent at all.

Many people are willing to donate organs and tissue after their death, but they want to have their say about what organs or tissue will be taken from their bodies and what that will be used for. That is why the fundamental premise of the bill is so important. The bill is based on the principle that people's wishes should be respected after their death. That means that it is for each person to make those wishes clear. If that has not happened, authorisation must be obtained from the people who were closest to that person in life and who are most likely to know his or her wishes. Without authorisation from the deceased or their nearest relative, transplantation cannot happen. On that basis, I hope that Stewart Maxwell will accept that what he says he wants will be delivered by the fundamental principles of the bill as it stands.

Under Mr Munro's amendments, the only wish that people would be able to record would be to prohibit the removal and use after death of their body parts for transplantation. Where there is no prohibition, the adult may be deemed to have authorised the removal and use of organs but only—as Dennis Canavan pointed out—after their nearest relative has also had the opportunity to object to donation going ahead.

There are a number of grounds on which the nearest relative can object to organ donation, despite the fact that the deceased person had not registered their objection to their organs being donated. One of those is that transplantation of the deceased adult's body parts would cause significant distress to the nearest relative or to the deceased person's partner, parent, child, brother or sister.

A clinician who was in urgent need of an organ would face a much harder task if Mr Munro's amendments were passed. Under the current system, which we wish to replace, he or she would have to seek the consent of the family of the deceased. Under the provisions in the bill, that onus on the clinician will no longer be required if a person has, before their death, authorised organ donation. The nearest relative would need to be consulted only if no such authorisation had been given. In that event, the nearest relative would be asked whether they knew the person's wishes and were prepared to authorise organ donation.

Under Mr Munro's amendments, the clinician would always have to contact the nearest relative unless a specific prohibition had been registered by the deceased. The nearest relative could then object on the basis of the distress to themselves or another person in the family that would be caused by the transplantation. In other words, there would be not fewer barriers to organ donation—which is John Farquhar Munro's intention—but new barriers to organ donation. In practice, if a person wanted to donate their body parts, that positive intention could be ignored and overruled by the nearest relative on the basis of the distress that might be caused to family members.

John Swinburne (SSCUP, Central Scotland)

Will there be a national register of people who want to donate human parts after death?

Lewis Macdonald (Labour, Aberdeen Central)

That is precisely what the bill will do. It will place at the centre of the process the authorisation that has been granted by an individual, rather than an objection that might have been registered by that individual or another person, which is what would be required under a system involving presumed consent.

It has been said that about a quarter of the Scottish population have put their names on the NHS organ donor register. Under the bill, their organs will automatically be available for transplantation after death. Under John Farquhar Munro's amendments, nobody's body would be available in that sense; every case would have to be checked with the nearest relative by the clinician, unless a prohibition was in place.

The approach that the bill takes is the right one. It will increase the number of organ donations, honour the wishes of the deceased and bring up to date the basis on which relatives are approached.

This is a policy matter—it is not simply a matter of personal belief. I therefore urge John Farquhar Munro to seek to withdraw his amendments. If he will not do so, I urge Parliament to maintain the unanimity of support for the principle of active authorisation by rejecting his amendments.

John Farquhar Munro (Liberal Democrat, Ross, Skye and Inverness West)

The majority of opinion seems to be opposed to what I propose, which is disappointing.

I support the Executive's proposal in the bill. It is an excellent move and a big improvement on what we have at the moment. However, I introduced the concept of presumed consent to enhance and improve the bill. As a consequence, I would like to test the feeling of Parliament, so I propose that my amendment be voted on.

Trish Godman (Labour, West Renfrewshire)

The question is, that amendment 11 be agreed to. Are we agreed?

Trish Godman (Labour, West Renfrewshire)

There will be a division. I suspend the meeting for five minutes.

Trish Godman (Labour, West Renfrewshire)

We will now proceed with the division.

Trish Godman (Labour, West Renfrewshire)

The result of the division is: For 18, Against 87, Abstentions 0.

Amendment 11 disagreed to.

Trish Godman (Labour, West Renfrewshire)

The amendments in group 2 are technical or consequential amendments. Amendment 1, in the name of the minister, is grouped with amendments 38, 61, 5, 6 and 7.

Lewis Macdonald (Labour, Aberdeen Central)

As you mentioned, Presiding Officer, the amendments in group 2 are technical or consequential amendments. Amendments 38 and 61 follow the amendments that were made at stage 2 to prohibit the withdrawal of authorisation for transplantation after it has been given by an adult's nearest relative or, in the case of a child, by a person with parental rights and responsibilities.

Amendments 5 and 6 seek to ensure that an adult who is blind or unable to write is able to withdraw authorisation for post-mortem examination in writing through the use of a signatory and a witness. They complete the package of amendments that we have lodged to make provision for people in that category. Amendments 1 and 7 are simply drafting amendments.

I move amendment 1.

Trish Godman (Labour, West Renfrewshire)

I refer members to the list of groupings, which shows the pre-emptions.

Amendment 1 agreed to.

Trish Godman (Labour, West Renfrewshire)

Group 3 is on the disapplication of the authorisation requirements in parts 1 and 2 for the bodies of persons who have been dead for at least 100 years. Amendment 2, in the name of the minister, is grouped with amendment 4.

Lewis Macdonald (Labour, Aberdeen Central)

Amendments 2 and 4 were lodged as a result of concerns expressed by the Wellcome Trust and the Medical Research Council to the Executive about the possibility that the bill would curtail investigations of bodies of historical interest. Much can be learned from the removal of a tissue sample from a body that has been held in an existing collection for many decades. If an ancient body is discovered preserved in a peat bog, researchers will naturally be keen to examine the body for the information that it might yield—for example, on the cause of death. Under the bill, such investigations might conceivably be held to constitute an offence, because no authorisation for such activities would be in place from the individual or from identifiable family members, for obvious reasons.

We do not want scientists to have to investigate the family tree of a body in a peat bog before they undertake carbon dating of it. Therefore, amendment 2 disapplies the authorisation and offence provisions in part 1 in cases in which the person died at least 100 years before the day on which section 3 comes into force. Amendment 4 does the same in relation to part 2, on post-mortem examinations.

The amendments are drafted broadly so that they will permit anything involved in relation to the body of a deceased person, where the person died at least 100 years before the day on which the relevant provision comes into force.

Amendment 2 moved—[Lewis Macdonald]—and agreed to.

Trish Godman (Labour, West Renfrewshire)

The question is, that amendment 13 be agreed to. Are we agreed?

Trish Godman (Labour, West Renfrewshire)

There will be a division.

Trish Godman (Labour, West Renfrewshire)

The result of the division is: For 18, Against 84, Abstentions 0.

Amendment 13 disagreed to.

Amendment 14 not moved.

Trish Godman (Labour, West Renfrewshire)

Group 4 is on the prohibition of the use of body parts for transplantation. If members look at the list of groupings, they will see the pre-emptions. Amendment 15, in the name of Nanette Milne, is grouped with the amendments shown in the papers.

Nanette Milne (Conservative, North East Scotland)

I will speak principally to amendments 15 and 17, because the others are all consequential on amendment 15. If the amendments appear to be somewhat complicated, that is because they reflect the complexity of the bill.

The amendments would enable a person to register opposition to the removal of a body part after death for the purpose of transplantation, research, education, training or audit. They would give the choice actively to prohibit the removal of a body part as well as actively to authorise it. They address the potential problem that would face a person who does not know his nearest relatives and so cannot make his wishes known to them, or who does not trust them to act on his wishes. Without the amendments, such a person could not prevent unknown or unreliable relatives from making the decision to have body parts used after death against the person's wishes.

We feel that the absence of a fail-safe mechanism to allow people to record their wishes, whether positive or negative, is a cause for concern. The amendments would allow for everyone's wish to be respected and accepted, and would prevent an unethical situation arising should a decision go against the real wishes of a deceased person.

Apart from amendment 17, the amendments in the group are consequential on amendment 15.

They mirror the structure of the bill, so that each time the authorisation process is mentioned, the choice of prohibiting authorisation will also be mentioned.

The amendments do not apply to children who are under the age of 12, but they do apply to those who are aged between 12 and 16. If children who are between the ages of 12 and 16 can authorise, it is logical that they should also be allowed to prohibit donation.

The amendments also reach into the area of checking the relevant paperwork after death, to ensure that medical practitioners check for prohibition as well authorisation before removing body parts for transplantation and so on.

Amendment 17 addresses the situation that could arise if conflicting mandates are in place. It makes it clear that the terms of the later authorisation should be followed. For example, if the first mandate stated that all organs could be donated following death, and then another was drawn up afterwards that stated that all organs could be donated apart from the corneas, the latter would be acted upon as reflecting the true wishes of the deceased person.

The amendments do not seek to introduce a register for prohibition because, as was made clear in evidence to the Health Committee, there are many ways of registering authorisation, whether through the donor register, verbally or in writing; therefore, neither should notice of prohibition be limited to a register. Again, that mirrors the provisions in the bill. However, the bill does not prevent the setting-up of a register and the issue could be revisited in future if necessary.

It seems to me only right that people who feel strongly about the matter should be given the opportunity to record their opposition to the removal of some or all of their body parts for the purposes stated in the bill.

I move amendment 15.

Euan Robson (Liberal Democrat, Roxburgh and Berwickshire)

I read the amendments with interest, and I believe that they would add an unnecessary level of complication. If the individual wishes to prohibit the use of all their body parts, they need only not actively authorise use, and there are other methods by which someone who does not wish one or more of their body parts to be used, but is quite prepared for other parts to be used, can make that clear without having a level of complication in the bill that puts the use of certain body parts on a sort of statutory basis. I fail to see why the bill would need to go into such a level of complication and detail when, if an individual does not wish a particular body part to be used, they can express that very clearly to their relatives during their lifetime.

Although I understand the intention behind the amendments, they would lead to a level of complication and difficulty in the bill—and perhaps to some unforeseen circumstances in certain aspects of the day-to-day working of the bill—that would be unfortunate. In times to come, we might need to revisit the subject if clear difficulties arise from the practical application of the bill. However, at this stage, I am not minded to support the amendments.

Lewis Macdonald (Labour, Aberdeen Central)

Nanette Milne's amendments respond to very serious discussions at stage 1, but I do not believe that they are necessary or appropriate. I do not think that we should extend the organ donor register to become a register of both authorisations and prohibition; nor should we set up and run a separate register of organ donation prohibitions. Whichever vehicle was used to implement the amendments, it would run directly counter to the purpose of the bill, which is first and foremost to support people's wish to do something positive after their death. That is the principle behind authorisation.

I recognise that there are people who do not want parts of their bodies to be used for the purposes in the bill and who might feel strongly about that. I fully accept the principle that their wishes should be respected, but I am confident that the bill will allow such objections to donation to be respected. The first safeguard in the bill is that nothing can happen if there is no authorisation by the person, or by their nearest relative or a person with parental rights and responsibilities. There can be no transplantation by default, nor—because of the decision that we made a few minutes ago—can there be any transplantation on the basis of presumed consent. The bill underlines that by bringing criminal sanctions to bear. If a clinician were to proceed without authorisation, they would face stiff penalties, including a fine or imprisonment, or both.

Where there is no record of the person's wishes, we seek to address the concern that a family member might sanction a donation through ignorance by placing responsibility for authorisation on the person who was closest to the deceased in life and so is most likely to have the greatest awareness of the deceased's attitude to the issues.

Section 7 makes it clear that where the nearest relative has "actual knowledge" that the person was unwilling for any part of their body to be used for transplantation, they must not give authorisation. The reality is that people who feel strongly about such matters will not keep their feelings to themselves. They will share their views with their family and friends. If their views have a religious dimension, they will no doubt share them with others of the same faith. It is hard to envisage strong views on such a matter being unknown to any of those who might be asked.

That would leave only the highly unusual case of a person living in isolation, either without any surviving relatives or, for some reason, unable or unwilling to mention to anyone close to them their own strongly held views on such matters. Of course, if people in that position object to organ donation, their wishes should be respected as much as anyone else's, but I do not believe that recording those wishes in a register set up for that purpose, or in the organ donor register, is the way to do that. In such cases, people can set out their wishes in their will, and they can also ensure that their views are reflected in the medical record held by their general practitioner.

I think that the medical record is the best place for such views to be recorded, because if there was the possibility of somebody becoming an organ donor, the clinician would either contact that person's GP or, if they were unable to do that, consult the person's medical record. No clinician will proceed with a transplant involving an organ about which he or she is not fully informed. Recording wishes in that way is the key and can already be done routinely, either verbally or by writing to one's GP setting out one's objections and asking for the letter to be added to the medical record.

I understand the concerns behind Nanette Milne's amendments, and I am happy to offer guidance to GPs to ensure that they include any such objection in a patient's record. I will tell GPs that any such objections should also be included in the extract from medical records that they provide to NHS 24. In the near future, the introduction of the electronic health record will provide a further vehicle by which an objection recorded by a GP can be accessed readily by a transplant co-ordinator seeking a donor. In addition, we are working with the General Medical Council on including in its "Good Medical Practice" guidance, which applies to all doctors, a provision making clear a doctor's duty to respect the wishes of his or her patients after death.

I ask Nanette Milne to consider withdrawing her amendments on the basis of the assurance that I have been able to give today.

Nanette Milne (Conservative, North East Scotland)

I lodged the amendments in the group precisely to deal with the isolated people whom the minister mentioned—people who do not have relatives in this country or close by to whom they have been able to express their wishes, and who feel strongly about not donating their organs. It has been made quite clear to me by the Scottish Council on Human Bioethics that there are people who are currently considering withdrawing their names form the organ donor list if the bill is not amended to take account of the fact that some of them specifically do not want to donate certain organs, because they feel so strongly about the issue. It would be regrettable if a bill that attempts to increase organ donation were to lead to the loss of even two or three donors. I appreciate what the minister has said about offering guidance, but I will press amendment 15.

Trish Godman (Labour, West Renfrewshire)

The question is, that amendment 15 be agreed to. Are we agreed?

Trish Godman (Labour, West Renfrewshire)

There will be a division.

Trish Godman (Labour, West Renfrewshire)

The result of the division is: For 13, Against 67, Abstentions 0.

Amendment 15 disagreed to.

Trish Godman (Labour, West Renfrewshire)

Amendment 16, in the name of John Farquhar Munro, has already been debated with amendment 11. I ask John Farquhar Munro to indicate whether he intends to move amendment 16.

John Farquhar Munro (Liberal Democrat, Ross, Skye and Inverness West)

I do not intend to move amendment 16. There is also a list of amendments in my name further on in the marshalled list, and I would like to withdraw all those amendments at this stage.

Trish Godman (Labour, West Renfrewshire)

That is a good idea, but I am afraid that I cannot allow you to do that. However, I will be as quick as I possibly can be when I come to that point in the proceedings.

John Farquhar Munro (Liberal Democrat, Ross, Skye and Inverness West)

I just thought that it might save us some time.

Trish Godman (Labour, West Renfrewshire)

It would have done and I am grateful for your suggestion, but I am afraid that we have to have each decision to move or not to move amendments properly recorded.

Amendments 16 to 23 not moved.

Trish Godman (Labour, West Renfrewshire)

Amendment 38 pre-empts amendment 39.

Trish Godman (Labour, West Renfrewshire)

Group 5 is on authorisation by the nearest relative when no person has parental rights or responsibilities. Amendment 59, in the name of Eleanor Scott, is grouped with amendments 63, 109 and 111 to 113.

Eleanor Scott (Green, Highlands and Islands)

I should begin by declaring an interest, as I am a member of the British Medical Association.

Amendment 59 and the other amendments in the group, which are in my name, are very much in the spirit of the rest of the bill, and are simply intended to close a gap. In debating the bill, we are dealing with highly sensitive matters, none more so than the death of a child.

The sudden death of a child is always devastating and an unspeakable tragedy for the child's family. Some families can find a small measure of consolation if their dead child's organs can give life to another child. In general, the bill provides for that, but it makes no provision for the rare eventuality of no one having parental rights at the time of the child's death. One can all too easily envisage a situation that might arise if a whole family were involved in a fatal accident, when both parents were killed and the child later died of his or her injuries. As the bill stands, another relative could give permission for the parents' organs to be donated, but no one could give similar permission for the child's.

If the parents are unable to consent to their child's organs being donated because they have been killed or so severely injured that they are unable to give consent, a near relative should be able to give consent. That is what amendments 59 and 63 would do.

I will read out amendment 109, which gives the hierarchy of relatives in the order in which they can be asked for permission. That hierarchy is in line with the one elsewhere in the bill for adults, but it is the other way round. The amendment states:

"For the purposes of sections 10 and 11, the nearest relative is the person who immediately before the child's death was—

(a) the child's parent;

(b) the child's adult brother or sister;

(c) the child's grandparent;

(d) the child's adult uncle or aunt;

(e) the child's adult cousin;

(f) the child's adult niece or nephew."

That is similar to the hierarchy for adults, except that it does not include provision for a family friend to give permission if no relatives are found. I felt that that would not be appropriate in the circumstances.

Amendment 111 clarifies that the hierarchy outlined in amendment 109 includes step-parents and half-siblings, which is in line with the rest of the bill.

Amendments 112 and 113 are essentially tidying-up amendments. Amendment 113 provides that a relative can be skipped in the hierarchy if he or she either does not want to make the decision or cannot realistically be contacted. That parallels the provisions in the bill for adults.

My amendments would close a gap and are in line with the intention of the bill.

I move amendment 59.

Lewis Macdonald (Labour, Aberdeen Central)

As Eleanor Scott said, the amendments stem from concerns that were expressed in evidence that the BMA submitted to the Health Committee at stage 1.

As with other amendments this morning, we have sympathy with the concerns expressed and the motives that lie behind them, particularly in the context of transplantation, where there would—in a very few cases—be a risk of valuable organs not being used because there was no one to give the necessary authorisation.

This is a complex area, but to some extent the matter is already addressed in Scots law. Section 7 of the Children (Scotland) Act 1995 allows parents to appoint guardians for their children in the event of the parents' death. That means that, if the parents die, the appointed guardian immediately becomes responsible and takes over parental rights and responsibilities. The guardian would, as a result, be classed as the person who had parental rights and would, therefore, in the circumstances that Eleanor Scott describes, be able to give authorisation for a transplantation to go ahead.

That outcome would, of course, require parents to have appointed a guardian under the 1995 act. In any case, we are committed to raising people's awareness of what might happen after a person's death. One issue that we will want to highlight, and which reflects Eleanor Scott's concerns, is that parents should always take the precaution of appointing a guardian who would have responsibility for their children after their death.

Stewart Maxwell (Scottish National Party, West of Scotland)

The minister's approach seems strange. He says that he will take on board the concerns expressed by Eleanor Scott and try to make parents appoint a guardian. Frankly, I would be surprised if anyone in the chamber had appointed a guardian in the way that he suggests. I certainly have not appointed a guardian in the event of a car crash in which my wife, my daughter and I are all fatally injured. Why not accept Eleanor Scott's amendments and deal with the problem here and now?

Lewis Macdonald (Labour, Aberdeen Central)

Public awareness raising clearly must start in the chamber. All of us who have children should have regard to their interests in the event that we die unexpectedly. Everyone in the chamber and elsewhere should be encouraged to do so, and to appoint a guardian to take parental responsibility if, tragically, the circumstances arise in which that is required.

The point that lies behind the amendments is reasonable. However, the amendments have only been lodged at stage 3, and I fear that they do not achieve their intended purpose. I will highlight a couple of issues.

First, the provisions would not apply to children for whom a local authority has parental rights and responsibilities, which in reality is a far more common occurrence than the car crash scenario that the amendments are intended to address. The bill was amended at stage 2 to address the Health Committee's recommendation that local authorities be prohibited from having the power to authorise any of the activities in the bill. Children for whom local authorities have parental rights and responsibilities would not be covered by Eleanor Scott's amendments. The changes that were made at stage 2 reflect the recognition—which we believe is right—that there will be occasions on which it is not proportionate to make provision for authorisation of organ donation on the part of a child.

The other aspect that gives me significant concern relates to amendment 109, on the nearest relative list. As presented, the list includes in the hierarchy a parent of a child, but does not provide for circumstances in which that parent has, for one reason or another, ceased to have parental rights and responsibilities. In some circumstances, a parent might have had his or her parental rights removed, for example if he or she had been involved in abuse of the child. It would be inconsistent to allow such a parent to have the right to give or withhold authorisation under the bill. Equally, there might be reasons why another relative did not have access to the child during their life, and in such a case the relative should not be given a role after the child's death.

I fully recognise the purpose of the amendments, but I believe that promoting the appropriate mechanisms whereby parents can ensure that their children's interests are looked after in the event that the parents die is the way forward. I therefore oppose the amendments in Eleanor Scott's name.

Eleanor Scott (Green, Highlands and Islands)

I point out to the minister that amendment 109 was lodged only at stage 3 because we had expected the Executive to plug the gap earlier in the process. Amendment 109 is intended to plug a gap that exists in the bill, and it is very much in the spirit of the bill.

I agree with the minister's comment that if a guardian had been appointed they would have parental rights, and my amendments would not come into play. However, as Stewart Maxwell said, the reality is that most people have not appointed a guardian. Perhaps in 10 or 15 years' time public awareness will be such that most people will have done so, but in the event of a child losing both parents in an accident now, they are likely to be left without anybody who has parental rights.

As I said in my opening speech, the death of a child is always a tragedy. The only greater tragedy is when a second child who might have been saved by the donated organs of the first child dies. We are talking about rare eventualities, but they are circumstances for which the bill should provide, so I press amendment 59.

Murray Tosh (Conservative, West of Scotland)

The question is, that amendment 59 be agreed to. Are we agreed?

Murray Tosh (Conservative, West of Scotland)

There will be a division.

Murray Tosh (Conservative, West of Scotland)

The result of the division is: For 39, Against 66, Abstentions 0.

Amendment 59 disagreed to.

Amendment 60 not moved.

Amendment 61 moved—[Lewis Macdonald]—and agreed to.

Murray Tosh (Conservative, West of Scotland)

Amendment 62 is pre-empted.

Des McNulty (Labour, Clydebank and Milngavie)

On a point of order, Presiding Officer. I ask the Presiding Officers to consider the point that, this morning, a whole series of very detailed stage 3 amendments has simply not been moved. They will have required a lot of work from ministers and civil servants. I wonder whether the issue could be examined with regard to efficient government and making our parliamentary processes more efficient.

Murray Tosh (Conservative, West of Scotland)

It is possible—indeed, probable—that if a member lodges a substantive amendment, the clerks will point out that a significant number of consequential amendments will be necessary. Each of those amendments requires to be moved in turn. However, it might be worth reflecting on the question whether there should be a mechanism to allow consequential amendments to be withdrawn if the substantive amendment is withdrawn. If that was the point of order to which Mr McNulty was heading—[Laughter]—the Presiding Officers will reflect on it.

I detect from the mood of the chamber that we should ignore the point of order and deal with the issue. [Applause.]

Murray Tosh (Conservative, West of Scotland)

Group 6 is on bodies that are being preserved for transplantation not being moved to other premises. Amendment 3, in the name of the minister, is the only amendment in the group.

Lewis Macdonald (Labour, Aberdeen Central)

In response to a stage 2 amendment from Dr Jean Turner, I gave a commitment to look again at section 13(1), which provides for the steps that can be taken by managers of NHS hospitals and registered independent health care premises to preserve bodies for transplantation.

Amendment 3 seeks to clarify that such managers will be able to move bodies or body parts to other premises only if authorisation is already in place. It will therefore not be permissible under the bill to transport a body or body part to other premises if authorisation for transplantation does not exist. Of course, in only a very few situations can a body be moved and still be available for transplantation, but doing so when no one has authorised transplantation might upset family members and could be viewed as disrespectful to the deceased.

I believe that amendment 3 clarifies the point in the spirit of the bill, as it makes provision for those very unusual circumstances on the basis of authorisation.

I move amendment 3.

Amendment 3 agreed to.

Murray Tosh (Conservative, West of Scotland)

Group 7 is on the meaning of "tissue" and "tissue sample". Amendment 8, in the name of the minister, is grouped with amendments 9 and 10.

Lewis Macdonald (Labour, Aberdeen Central)

The purpose of amendments 8, 9 and 10, which seek to adjust an existing definition in and add a further definition to the interpretation section of the bill, is to clarify a number of issues that were raised in evidence or were highlighted by the Health Committee.

Amendment 8 amends the definition of "tissue" in section 54(1) explicitly to define tissue as including skin, corneas and bone marrow.

Amendment 9 adds the phrase "any derivative of skin" to the definition of "tissue sample", which will allow such parts of the body including hair and nails to be retained from a post-mortem examination.

Amendment 10 is a technical amendment that is consequential to amendment 8. For the purposes of the bill, corneas will be included as a form of tissue, which reflects the way in which the transplantation community regards them.

Clarifying that skin is a form of tissue will allow living children and adults with incapacity to donate skin for the purposes of transplantation, subject to independent scrutiny by the Human Tissue Authority. It will also mean that adults with capacity will not be prohibited from donating skin.

In the post-mortem context, the amendments seek to clarify the meaning of "tissue sample" in section 23(5), which lists the parts of the body that can be retained from a post-mortem examination. As a result, "tissue sample" will be understood as including skin and derivatives of skin, such as hair and nails.

This group of amendments fulfils a commitment that I gave to the Health Committee at stage 2, and resolves the doubts that were raised about the status of certain types of human material under the bill.

I move amendment 8.

Amendment 8 agreed to.

Amendments 9 and 10 moved—[Lewis Macdonald]—and agreed to.

Murray Tosh (Conservative, West of Scotland)

That ends consideration of amendments.

Human Tissue (Scotland) Bill

Murray Tosh (Conservative, West of Scotland)

The next item of business is a debate on motion S2M-3785, in the name of Andy Kerr, that the Human Tissue (Scotland) Bill be passed.

Lewis Macdonald (Labour, Aberdeen Central)

This morning's consideration of amendments has been good and has reflected a broad consensus not on every issue but on the basic principle of the Human Tissue (Scotland) Bill that, wherever possible, we should respect and follow the positive wishes that the living express about what should happen to their bodies after death.

The Executive's stage 3 amendments have put some final touches to the bill and round off changes that were made at stage 2. I believe that the bill has been very much strengthened and improved by the range of amendments that have been agreed to, many of which were brought forward by the Executive as a response to comments made and issues raised at stage 1. The thoughtful and serious way in which issues were raised and debated at every stage is a credit to the Parliament, the Health Committee and all those involved in the process.

The process by which ministers sought to respond to members' views has been in keeping with our approach to the development of the bill. We started by responding to concerns about past practice in post-mortem examinations and we worked closely with patients representatives and with a range of clinicians to ensure that the bill supports and strengthens best practice in each of the areas with which it deals.

It is worth reflecting briefly on the main changes that have been agreed to the bill since our stage 1 debate on 30 November. First, we have incorporated an approach to donation by adults with incapacity that is in harmony with the principles in the Adults with Incapacity (Scotland) Act 2000. The bill, as amended at stage 2, now makes it clear that the only forms of donation that are open to a living adult with incapacity under part 1 of the bill are organ donation as part of a domino transplant operation or the donation of regenerative tissue. In practice, "regenerative tissue" will mean bone marrow and skin. Our consultation last autumn showed that there is general support for our approach. The approach will also apply to donation by living children.

We have also responded to concerns about the original definitions of the terms "organ" and "tissue" by clarifying the areas of uncertainty that members had raised, specifically to do with corneas and skin. We have made adjustments to the provisions in parts 1 to 3 of the bill relating to authorisation. In particular, we have made sure that the needs of those who are blind or unable to write can be taken into account for each type of authorisation and for the withdrawal of authorisation.

The key feature of the bill is that the concept of authorisation has replaced the concept of consent. By "authorisation", we mean the way in which people express their wishes about what they want to happen to their body after death. We use the word in the sense of, "I give my authorisation for the use of any part of my body after my death for the purpose of transplantation." That is a very direct and forceful statement for a person to make, as it allows the individual to take the initiative in making their views known.

Kenneth Macintosh (Labour, Eastwood)

Does the minister accept that, despite the vote this morning, many of us have every sympathy with the amendments lodged by John Farquhar Munro on presumed consent? I echo the words of my colleague Janis Hughes, who said that, although we could not move to a system of presumed consent, that is not the end of the matter. If we can regain trust in the system, presumed consent may one day be a possibility.

Lewis Macdonald (Labour, Aberdeen Central)

It is certainly worth saying that one of the purposes of the bill is exactly what Ken Macintosh says: to regain trust in the system of organ donation and post-mortem examination. I believe that we will be able to move forward. However, it is important to acknowledge that passing the bill today will be the biggest contribution that we can make to increasing the number of organs that are available for donation. The wishes of the quarter of the Scottish population—more than a million people—who have already indicated that they would like their organs to be used for transplantation after death will now have legal force. As Mike Rumbles said, that is new and significant. The bill will significantly increase the number of organs that are available for donation. On that basis and on the basis of the trust that would thereby be regained, more and more people will register as donors.

The bill will also update the Anatomy Act 1984. In response to evidence that was given at stage 1, we introduced amendments at stage 2 that provide more stringent controls on authorisation by children aged 12 to 15. The amendments will exclude bona fide museums from the need to be licensed for the public display of anatomical human remains. They will allow, subject to conditions, the public display of a wide range of anatomical human remains in the interests of education, training or research, including the health education of the general public.

We have had a thorough debate on the principles of the bill from stage 1 on and we have just had a full debate about how those principles are best applied in today's circumstances. The Parliament's support for those principles is to be welcomed. The bill is about respecting people's wishes by giving effect to them after a person's death; that respect is enshrined in the principle of authorisation. The bill modernises and replaces the unsatisfactory approach that exists in the current legislation and it gives us a system in relation to transplant matters that is fit for purpose in the 21st century.

I move,

That the Parliament agrees that the Human Tissue (Scotland) Bill be passed.

Shona Robison (Scottish National Party, Dundee East)

The Scottish National Party is pleased to support the Human Tissue (Scotland) Bill at stage 3. I would like to thank all those who gave evidence to the Health Committee. It is crucial that the focus of the bill has been on determining the wishes of the deceased and on ensuring that those wishes are respected. The concept of authorisation should ensure that a person's wishes are respected if those wishes are registered in some way and that, when no wishes have been registered, there is a clear process for ascertaining any wish that the deceased might have made and for seeking authorisation through the nearest relative hierarchy.

The hope is that, by strengthening the opt-in system, there will be an increase in the number of organ donations in Scotland. There are members in all parties who favour a system of presumed consent, as expressed by John Farquhar Munro and others. However, the Parliament made the right decision in rejecting the amendments that called for the introduction of presumed consent. It is important that we build public confidence in the system, which proposals for a system of presumed consent would not do.

The new system of informed consent should make it easier to ascertain a person's wishes. As we know, most people would want to donate their organs, so, alongside the new legislation, a public awareness campaign will be crucial in encouraging more people to register their wishes and to discuss them with family members. The rules for living donation in the bill are sensible.

It is essential that the bill should provide the required reassurance to parents and others who find themselves in the traumatic situation of having to deal with a hospital post mortem. Procedures have already changed in the wake of what happened at Alder Hey children's hospital, but it is crucial that we frame such changes in legislation. The concept of authorisation also applies to hospital post mortems, although it is complicated by the fact that different standards of authorisation are required in different cases. Concerns about that were expressed during the progress of the bill. The minister has gone some way to reassure us that the guidance on authorisation will be very clear. It is right that the penalties for a breach of procedure will be severe—they must be so that public confidence is restored and the public is reassured that scandals like Alder Hey do not happen in future.

With regard to the reform of the Anatomy Act 1984, there is a need to ensure that human body parts are not displayed for purely entertainment purposes and that they are treated with respect. The amendments to the bill provide reassurance that that need will be respected. I compliment the minister on going out of his way to provide reassurance and to lodge amendments in answer to concerns that were raised.

The bill's overarching aim is to increase organ donation and therefore the number of lives saved. I hope that we will have a system for carefully monitoring the impact of the legislation in achieving that aim. I hope that the minister, in his summing up, will tell us how he will ensure that such a monitoring system is introduced and that there will be regular feedback to the Parliament on the success of the legislation.

Nanette Milne (Conservative, North East Scotland)

I, too, thank all those who gave evidence to the Health Committee. I also thank the committee clerks and lawyers who guided me through the plethora of amendments—which arose from one policy intention—in my name at stage 3. The Conservatives welcome this complex and important bill, with its separate provision for, first, organ and tissue donation and, secondly, the retention of organs and tissues at post mortem.

The new framework for organ donation and transplantation at post-mortem examinations and the associated removal, retention and use of body parts should go a long way to ensuring that the wishes of the deceased and their families are respected. It should in future spare bereaved families the distress that was caused to relatives in the past by the discovery that their loved ones' organs had been removed at post mortem and retained without their knowledge or permission.

The updating of the provisions in the Anatomy Act 1984 on anatomical examination and the public display of bodies and body parts is welcome, too. We had concerns about the lack of clarity of the bill as introduced on biomedical research and its proposal of an overly restrictive licensing system to control public display. However, the Executive dealt with those worries at stage 2 and we are happy with its amendments. We are satisfied that the Executive has gone a considerable way to acknowledging the need for clear definitions of "tissue", "organs" and "body parts", so that people who sign authorisation forms are sure about exactly what they are authorising. That is an important part of fostering trust between the medical profession and the public and we welcome the minister's response to the concerns that were raised.

With regard to organ donation and transplantation, we are pleased that authorisation by a potential donor cannot be overruled by relatives after the person's death because we feel that it is important that the informed consent of a donor is respected. The strengthening of the opt-in system, coupled with the intention to promote, support and develop programmes of transplantation that is clearly expressed in the bill, should help to increase the level of organ donation, without progressing us to the point—at this time—of having the opt-out policy that exists in Spain, which was promoted in some of the amendments that we considered earlier. As I have said on previous occasions, even in Spain it is acknowledged that the most important factor for the identification of donors is not the opt-out system but the availability of staff in hospitals who are responsible for identifying possible donors.

Valid concerns have been expressed to me that the bill does not provide a fail-safe mechanism for ensuring that the wishes of those people who object to donation are respected. In cases in which the deceased person has not made known their wishes prior to death, the bill allows for a soft form of presumed consent; in other words, it provides for an opt-out system that is similar to the one that is used in Spain. The fact that it does not make provision for people who object to donation in general or to the donation of specific organs is of serious concern to some people who do not know their nearest relatives or who do not trust them to respect their wishes.

As I said during our consideration of amendments, the Scottish Council on Human Bioethics has stated that it is aware of a number of single people who are considering taking their names off the national health service organ donor register—

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

I was a little puzzled by the member's assertion that the bill offers a form of presumed consent, because the bill is based on authorisation. It is fine if someone has authorised organ donation in the past, but those people whose names will appear on the list will be asked to give authorisation. There is no presumed consent.

Nanette Milne (Conservative, North East Scotland)

I was referring to cases in which the deceased has not stated their wishes and they have no close relatives who might know their wishes. The Scottish Council on Human Bioethics certainly interprets what the bill proposes as a soft opt-out system. Some people are considering removing their names from the organ donor register and it would be a tragedy if they were to do so because they were afraid that their wishes would not be implemented.

I welcome the minister's offer of guidance on the matter, but I am disappointed that Parliament rejected my stage 3 amendments because, like the minister, I want as many potential organ donors as possible to come forward to help the many people in Scotland who are suffering end-organ failure. My son would not be alive today but for the generosity of a donor family and I would not want to lose even one donor because of their fear that their wishes would not be respected.

However, all in all, I welcome the bill's provisions. The Executive's amendments go a long way to alleviating the concerns that the Health Committee and others expressed at stage 1. As a result, the bill has been improved significantly. It represents a great advance on the Human Tissue Act 1961, which it replaces, and we will be happy to give it our support at decision time.

Euan Robson (Liberal Democrat, Roxburgh and Berwickshire)

The Liberal Democrats welcomed the bill's introduction in June last year and, in common with all members, we are gratified to have watched its subsequent progress. I pass on my party's thanks and appreciation to everyone who has made the bill's passage to this stage possible. The Health Committee, its witnesses and ministers have all made major contributions to what is another important success for the Scottish Parliament. The bill is an example of progressive reform of outdated legislation and a clear response to some of the public concerns that were raised in cases to which other members have referred.

The bill modernises, clarifies and improves the law in the areas of organ and tissue donation, transplantation and hospital post-mortem examination. It deals with deficiencies in the law in the difficult area of the use of bodies and body parts. The first of its five key objectives is to repeal the Human Tissue Act 1961 and to replace it with separate provision for, first, organ and tissue donation and transplantation and, secondly, hospital post mortems. Its second and third objectives are to make clear the purposes of a post-mortem examination and to introduce the concept of authorisation for obtaining permission for organ donation, post-mortem examinations and the removal and retention of body parts at post mortem. Fourthly, it provides for authorisation for the retention and use of organs and tissue that have been removed during post-mortem examination and, fifthly, it seeks to amend the Anatomy Act 1984 on the use and display of bodies and body parts.

The key debate has been about the difference between informed consent and presumed consent. To move to a system of presumed consent would be a highly significant—indeed, a radical—change. As was said during consideration of the first group of amendments earlier this morning, the NHS is founded on the principle of informed consent. In my view, a change from a system of informed consent to one of presumed consent would require a sea change in public opinion and, frankly, I do not detect such a shift.

Many members have said that an increase in levels of organ donation is essential for the 400 or so people who are waiting for transplants, and everyone can agree with that. Given that we need to encourage more people to register, a public awareness campaign is necessary, but the key is the bill's purpose of restoring trust in the system. If people trust the system, they are more likely to engage with it.

In summary, the bill moves us from a position of passive consent to one in which active authorisation is required, but it does not provide for a system of presumed consent, in which individuals would have to register to dissent from the use of their organs. As Ken Macintosh has said, public opinion may move further on the issue in time and, in all probability, much will depend on the success of the public awareness campaign and the number of people who register for organ donation.

I was pleased that during this morning's stage 3 consideration of amendments the minister gave an assurance that guidance would be issued for the benefit of people who object to the use of certain but not all of their body parts. Guidance is important in such an interesting and difficult area. Like other members, I would regret it if people chose to withdraw their consent because they felt uncertain. Although the Executive rejected the amendments on that subject that were considered this morning, it acknowledged that a genuine issue was being raised. It is therefore incumbent on the Executive to provide the maximum possible reassurance to those people who find themselves in that position. I hope that very few people will consider withdrawing from organ donation as a consequence of what is in the relevant part of the bill.

The minister sent a letter on foetal tissue to the convener of the Health Committee and I welcome the assurance that it gave that guidance will be issued on that particularly difficult area. I hope and believe that both that letter and the guidance that will be issued will help.

Today we have considered some valuable amendments that responded to issues that were raised during the committee stages. The genealogy profession may not be expanded as a result of the amendment on bodies that are more than 100 years old, but it was nonetheless an important amendment.

Overall, the bill is extremely valuable. The Liberal Democrats have supported it from the outset and have supported the changes that it has been necessary to make to it. We commend it to the Parliament and will be pleased to vote for it this evening.

Eleanor Scott (Green, Highlands and Islands)

I will be brief. I simply want to put on record my and my party's support for the bill, which addresses issues of public concern. It will provide clarity on the law on hospital post mortems and on the difference between authorisation for post mortem and authorisation for organ retention. I hope that the bill results in increased confidence and trust among the public that their bodies and those of their relatives will be treated after death in the way in which they wish. I also hope that it will encourage people to make their wishes clear prior to their death.

Of course, I am disappointed that the amendments in my name, which would have allowed consent to a child's organs being donated to be given by the nearest relative in the event of the death of both parents, were not agreed to. I will not revisit that debate, but I thank all those who helped with the drafting of the amendments. I supported the amendments in the name of John Farquhar Munro on the introduction of a system of presumed consent. I would like to think that, through a process of awareness raising and perhaps by training and changing practice in hospitals, we can greatly increase the number of organ donations. I share Ken Macintosh's view that the issue may have to be revisited.

I welcome the bill and I thank all those who have worked on it.

Janis Hughes (Labour, Glasgow Rutherglen)

As other members have done, I thank the Health Committee clerks who, over the past few years, have had to deal with a steady stream of proposed legislation and inquiries. I record my sincere appreciation for the support that they offer members, which was crucial as we dealt with the sensitive issues that surround organ donation and retention. I pay tribute to those who gave evidence to the committee during our stage 1 deliberations. For many of them, the experience was emotional, so I thank them for their valuable assistance and contribution. I am sure that the bill is all the better for that.

As with last week's debate on prescription charges, there is consensus that we need a new approach to organ donation. As I have mentioned before, I worked in a renal unit for 11 years, where I saw at first hand the difficulties that are faced by patients who suffer from renal failure. All too often, they have to wait an inordinate amount of time for a suitable donor to be found. I support the bill because it will make a real difference to the lives of many people in Scotland. However, the Executive must take the lead on the matter, because the bill will not in itself result in a huge increase in the availability of organs. The Executive must do as much as possible to raise awareness of the importance of organ donation. As Shona Robison said, a high-profile public information campaign is vital. I urge the minister to ensure that that takes place should the bill be passed.

Much has been done to raise awareness of organ donation, but there is still a huge disparity between the level of support for donation and the number of organs that become available. It has been argued, forcefully in some quarters, that a system of presumed consent would remedy the problem. As I said earlier, I have sympathy with John Farquhar Munro's arguments in relation to presumed consent, but I do not believe that the timing is right for the introduction of such a system. As the issue is extremely sensitive, we would need to be sure that there was significant public understanding of and support for such a move, but I am not convinced that we can say that at this stage. I do not believe that the bill is the correct vehicle with which to achieve John Farquhar Munro's aim. Nonetheless, like Ken Macintosh, I hope that the matter will be considered further. As has been said, we should first increase public confidence in the system; that is what the bill, if it is passed today, will achieve. If we assume that a system of presumed consent would not be right at this time, it is surely even more incumbent on the Executive to do as much as possible to transfer the support for organ donation into positive action.

Nanette Milne's amendments raised important issues but, ultimately, I was not persuaded that they were necessary. I note that Nanette Milne did not move most of her amendments. The bill starts from the fundamental principle that the individual's wishes should be paramount. We will move from a system of consent to one of authorisation. That is far more than just semantics, because the term "authorisation" implies a positive decision. As the minister said, if people do not give authorisation, that should be enough to indicate their wishes. As someone who has long argued for greater use of modern technology in our health service, I look forward to the introduction of the electronic patient record. We heard from the Executive that it will allow general practitioners to register patients' wishes. For those reasons, Nanette Milne's amendments were not necessary, although they allowed us to broaden the debate.

The bill ranks as one of the most important pieces of proposed legislation that the Parliament has considered. For people who are waiting for suitable donors, it will be a huge step forward. I hope that the Parliament will vote in favour of the bill—I will certainly give it my full support.

Mike Rumbles (Liberal Democrat, West Aberdeenshire and Kincardine)

We heard earlier that, last year, 52 Scots died while they were waiting for an organ transplant and that almost 700 Scots are waiting on the transplant list. Those figures are a stark reminder to members that, for every one of those people and their families, a real tragedy might be averted if we increase the number of transplants. The central aim of the bill is to increase the availability of transplants and to save lives. Therefore, the focus has always been on how best to achieve that objective and how best to save lives.

The Scottish Executive ministers' move away from a system of consent for transplants towards a far more appropriate system of authorisation is entirely the right approach to an emotive subject. It must be right that the wishes of the individual should be respected and that the opportunity should be given to ensure that their wishes are carried out. I understand the motives behind John Farquhar Munro's amendments on presumed consent, but I am pleased that they were defeated because they would have undermined the whole purpose of the bill. That was accepted by Health Committee members—John Farquhar Munro's proposals did not receive support from any committee member at stage 2. However, as Lewis Macdonald said, the bill will improve the current organ donation system.

I mentioned donor cards earlier. Part of the problem with the present donor card system is that, until the bill is passed, the cards will carry no legal authority. It comes as a surprise to many people that the cards and the organ donor register have no legal status. That means that relatives, who may be entirely unaware of the deceased's wishes, are asked to give consent to organ donation in obviously difficult circumstances. That is not a good situation, to say the least. However, the bill will give the organ donor card scheme legal status. The system of authorisation that the bill outlines is the right way in which to proceed, as it is based soundly on the clear wishes of the individual. If authorisation has been given, no other hurdle will need to be overcome. If the individual has not made clear a wish to donate—although 25 per cent of Scots have already done so—the nearest relative will be asked for authorisation to proceed. That huge improvement on the current system should lead to a dramatic improvement in transplant rates. As Janis Hughes said, to achieve the successful outcome that all members want, the bill must be combined with a comprehensive advertising campaign by the Scottish Executive.

The bill is a good one; it is perhaps one of the best bills that the Scottish Parliament will ever pass. It is good news for the families who are waiting for a transplant for their loved ones. I hope that, at decision time, the bill will be passed unanimously.

David Davidson (Conservative, North East Scotland)

The issue is sensitive, so I congratulate the Health Committee and the minister on the way in which the bill has been handled. Committee members have welcomed the evidence that was given on the bill. Since the Parliament began in 1999, all members have received regular communications from people expressing anxiety about permission and organ retention. There has been utter confusion on those issues, which, combined with the bad practice that has occurred in hospitals throughout the country, has led to bad press, which in turn has resulted in a complete lack of confidence and a lot of mistrust. I hope that the bill will set that right. If we do not have public trust and confidence, we have no chance of achieving a decent system of authorisation.

I can see where John Farquhar Munro's amendments on presumed consent came from, but the measures that he proposed would be a move too soon. The public are not ready for them and there is no appetite for his principles to be accepted at this time.

Others spoke about problems such as rising refusal rates, people withdrawing from the donor card scheme and the bad experiences at some hospitals before the bill was published. Shona Robison, along with Mike Rumbles and others, said that the system must be based on informed consent. I welcome the minister's definitions, which give clarity to and confirm the authorisation system. The guidance that will be issued to general practitioners is also welcome. GPs will be a vital link in maintaining patient records, but many of them do not know what is contained in their patient records. That process must be made easier. More people move around and do not necessarily live in the same area where their records are kept. The instant transfer of records and electronic access to them will make the scheme work. Access to authorised consent forms must be made easier.

Donor cards will have legal status, which is important, but I have sympathy for the argument that was made by the amendments in the name of Eleanor Scott and Nanette Milne. We could all highlight scenarios that are not covered by the bill's provisions; lawyers in particular could do that. The Executive must maintain an open mind in that respect should a particular case arise. In time, changes may have to be introduced by regulation to include particular cases, not to remove them from the provisions of the bill. The need to review the legislation was pointed out by Ken Macintosh and others.

Janis Hughes referred to the campaign to increase the number of organ donors. We must ensure that people are encouraged to sign up to donor schemes and give them confidence in the system. Some concerns in the biomedical field remain. However, the bill is a vast improvement on what was in place.

There is an issue concerning changes that relatives may wish to make to a deceased individual's donation request. A close eye must be kept on that. It will not be easy to increase trust in the various sectors involved. People still write to MSPs with their concerns about organ retention. Not just ministers, but health professionals can convince people about organ donations. When I ran several pharmacies, they all carried donor card application leaflets, mainly from the British Medical Association. Health Scotland has a role to play in promoting organ donor cards. Approximately 700 people are waiting for organ transplants and the number is increasing every year. After the bill is passed, I hope that some inroads will be made in reducing that figure to give hope to many people and their families.

Roseanna Cunningham (Scottish National Party, Perth)

The bill concerns organ donation, transplantation, post-mortem examination and research. For obvious reasons, the debate centred mainly on donation and transplantation provisions. This morning's debate has shown broad consent and support from all parties for the bill's proposals. The legislation is necessary because of advances in technology and medical science and widespread concern following the revelations about past practices at Alder Hey children's hospital, Bristol royal infirmary and other hospitals. We cannot gloss over those concerns or the serious nature of what occurred in those cases. At the Health Committee, such cases were forcibly presented in evidence as examples of presumed consent that had gone badly wrong and as a warning of what can happen if one presumes too much. That is why the committee took the view that it did.

The main debate has centred on presumed consent—on opting in or opting out. In evidence that the committee heard on post-mortem donations, it was clear that—despite the organ donor register, opt-outs and authorisations—the process would stall if relatives were in serious and evident distress. The professionals told us that, notwithstanding the existence of an organ donor card, they would not be happy to proceed if relatives were in serious distress. We learned that, even in Spain, which purports to operate an opt-out system, the same thing happens.

The Parliament was right to reject John Farquhar Munro's amendments. No matter what one thinks of the arguments, it would be quite wrong procedurally to introduce such a radical change to our system by means of amendments at stage 3.

I note Ken Macintosh's comments about presumed consent. Given the concerns about introducing such a provision at stage 3, I wonder whether presumed consent would be a suitable subject for a standalone debate in the chamber, at some point, simply to allow the arguments to be rehearsed in more detail. It would be interesting to see the outcome of such a debate.

One or two issues were raised to do with live donation and anomalies such as domino transplants. Members have noted that such concerns have been addressed. It is a testament to the Parliament's legislative process that anomalies were picked up and addressed at the committee stage and did not find their way into legislation—which might very well have happened in the past in another place.

Concerns were raised about complicated authorisation forms, which have now been considerably simplified. The legislative process has been extremely useful. However, Shona Robison, Janis Hughes and Mike Rumbles are absolutely right when they talk about the urgent need for publicity and education. That, of course, will require resources.

On the issue of presumed consent, I think that it was John Farquhar Munro who talked about the likelihood that the majority of people who are not currently on the organ donor register would not actually object to their organs being used. That may be true, but the answer lies not in moving towards presumed consent, but in encouraging more authorisation. With the greatest of respect to members, that will entail more than just advertising. We will have to go out to where people are and take the campaign to places such as the supermarkets and the high streets. I hope that the minister will come back to Parliament with some outreach proposals along those lines.

If the proponents of presumed consent stood outside supermarkets and actually asked people to sign up and give their authorisation there and then, we could test the assumptions about how many of the silent majority are relaxed about giving their agreement, and how many of them are just saying that they are relaxed while hiding their concerns. We have to be very careful about making assumptions. If the proponents of presumed consent are right, people will be happy to sign up there and then when they are offered the cards. There is a challenge for the minister. Let us proceed with such a campaign.

Although I am closing the debate for the SNP, I have had a long and close involvement in the passage of this bill as convener of the Health Committee. I thank once again all those who helped the committee during its discussions on the bill. In particular, I thank the clerks—especially for making written sense of our various verbal discussions—and all those who came to give evidence. Of course, I also thank the committee members themselves. It has been a bill of moral, medical and legal complexity.

I give a particular mention to the people whose concerns over some of the issues have been driven by deep personal and emotional connections. Chief among those people were the parents groups that were set up after the scandal over the retention of children's organs. For those people, the continuing debate must sometimes be very difficult indeed.

With those thanks to all involved, I commend the bill to Parliament.

Lewis Macdonald (Labour, Aberdeen Central)

I thank members across the Parliament for their support for the Human Tissue (Scotland) Bill, which they have demonstrated here at stage 1, in committee at stage 2, and here again this morning. The bill's passage through the Parliament has been assisted by a great many people, whose contributions I acknowledge. I thank the many individuals and organisations who took the time to work with ministers and with our officials, as well as with the Health Committee, on identifying the aspects of the bill that could be clarified and improved. I acknowledge those who responded to the various consultations and those who gave evidence to the Health Committee.

Members of the Health Committee deserve particular recognition for the careful way in which they considered the bill and for the measured way in which a potentially difficult debate was conducted. I put on record the Scottish Executive's thanks to the Health Committee clerks, who ensured the effective management of the committee stages of scrutiny, and I record my own particular appreciation for the hard work and commitment of the Executive's bill team throughout the process.

The bill gives us a modern system of authorisation for organ donation, post mortems and other purposes that is fit for the 21st century. I believe that the bill has been further strengthened by all the attention that it has received. It gives us an excellent basis from which to move forward. I have no doubt that, as Ken Macintosh suggested, the bill will restore and improve public confidence in the system of post-mortem examinations. I am equally convinced that it will give all the health professionals who are involved with post-mortem examinations renewed confidence about approaching family members in circumstances that are obviously very distressing. The expected increase in the number of examinations that I believe will result from the bill will yield enormous benefits, both for families and for society as a whole.

There is widespread support in the chamber for action to increase the number of organs that are available for transplantation and for ensuring that a person's wish to be a donor is not overturned after their death. Currently, families refuse to agree to donation going ahead in 40 to 50 per cent of cases. Our new system of authorisation, which is founded on honouring people's wishes, will mean that the person's own wishes are paramount. That will, I believe, lead to a considerable increase in the number of organs that become available.

We want to go further, however—as members have suggested in today's debate that we should do—and take advantage of the new legislation to develop further the transplantation infrastructure in Scotland. One of the key messages that we have gleaned from the evidence that was gathered during scrutiny of the bill is that we need to ensure that the right arrangements are in place and that we devote the necessary resources to the organisation of organ donation and transplantation. I am asking the Scottish transplant group to develop that, taking into account the views of NHS board chief executives and regional planning groups.

We have been asked about monitoring. We will monitor the impact of the eventual act on transplantation in every respect. The Scottish transplant group and UK Transplant will undertake that monitoring on our behalf, especially in relation to the organ donation rate in Scotland, which is clearly a matter of concern. On post mortems, the Executive will track the number of hospital post-mortem examinations and we will work with NHS Quality Improvement Scotland on monitoring the standards that apply to hospital post mortems. As regards aspects relating to the Anatomy Act 1984, the inspectorate arrangements that are in place will ensure on-going monitoring of the provisions.

Throughout the process, we have kept an eye on what has been happening with human tissue legislation in the rest of the United Kingdom. The bill will be a distinct piece of Scottish legislation, but we want to ensure consistency for people throughout the United Kingdom as far as possible, particularly when it comes to the timing of the introduction of the new arrangements. The Human Tissue Authority will scrutinise applications from Scotland for living donation, and it will do the same for the rest of the United Kingdom. The authority will be in a position to begin that work in the autumn. For that reason, the UK Human Tissue Act 2004 will not commence in England and Wales in general until 1 September this year.

Given the cross-border role of the Human Tissue Authority, that appears to offer us here in Scotland a very suitable commencement date. Commencement on 1 September will allow us time to put in place the training that health professionals and others will need to help them to implement the new legislation as effectively as possible. It will also allow us proper time to develop the regulations and guidance that will add detail to the bill's provisions, on which I have given further undertakings today. Above all, it will give us more time to raise public awareness and to inform people about the effects of the bill and its significance for each of us. That is the central message about the bill.

I advise Roseanna Cunningham that we will come back to the Parliament and say more about how we will carry forward the policy. A campaign is under way to encourage donation, and we will seek to put in place a registration campaign over the next few months. We will issue a Health Department letter to NHS boards, with guidance of the kind that I described earlier in the debate and at previous stages. Above all, the bill is about ensuring that everyone has the opportunity to make their wishes known.

One of the key changes under the bill is that the organ donor card will change from being a gesture of willingness to being a legal statement. Once the act comes into force, it will be even more important for people either to carry a donor card or to put their name on the organ donor register. Under the bill, those steps remain the two most convenient vehicles by which people may make their views known about what they wish to happen to their bodies after their death. The result is that carrying a donor card or putting our name on the register will count under the bill as a form of authorisation. The provisions of the bill will work to ensure that all such authorisations are respected. On that basis, we expect there to be a significant increase in the number of organs that are made available for donation.

A number of the points that have been made in the debate have emphasised how important it is that, as well as registering or carrying a card, people discuss their wishes with family members and those who are close to them so that, in the event of their death, those who might be asked about the person's wishes are aware of them. That is clearly a wise action to take, although it does not take the place of authorisation, which, as has been said during the debate, removes the requirement for a relative to be asked.

We will work with UK Transplant to change the wording on the existing forms that are available from general practices, from the Driver and Vehicle Licensing Agency, through passport applications and elsewhere, so that they reflect the new legislation. That will enable us to ensure that not only will we have changed the law but, at the point at which we implement it, a sustained effort will have been made to ensure that people can take advantage of the law and authorise donation if that is what they wish to do. Those who make a declaration to that effect will know that it has the backing of the law.

It is incumbent on each of us to take advantage of the power that the bill creates, whether that gives someone else the gift of life after our own death or enables medical research, which could save or enhance the life of future generations. We want to encourage every citizen to think about that. The decision on self-authorisation is one for each and every citizen to make, and we want to ensure that each and every citizen is aware of how the law is changing. We want to encourage people to give the matter serious thought.

David Davidson (Conservative, North East Scotland)

Will the Deputy Minister for Health and Community Care encourage the Minister for Education and Young People to consider ways in which schoolchildren can be taught about the background to the subject and what their rights will be in the future? In that way, authorising donation will become a part of growing up and a natural response.

Lewis Macdonald (Labour, Aberdeen Central)

That is a valid point. When we address the issue of how to raise awareness and ensure that that is the case, we will have regard to the fact that the law will make specific provision for children of secondary school age or over the age of 12. David Davidson's point is pertinent to that.

On that basis, and on the basis of the very broad support that we have heard this morning, I look forward to the vote later today confirming that the bill is the appropriate vehicle for the changes that we propose and that it has support across the Parliament.

Trish Godman (Labour, West Renfrewshire)

As we have reached the end of the debate before the time that is set out in the Business Bulletin for the next item of business, I suspend the meeting, under rule 7.4.1(d), until 11.40.

Question Time — Scottish Executive — General Questions

Charlie Gordon (Labour, Glasgow Cathcart)

To ask the Scottish Executive whether it will review the definition of "existing central heating system" within the context of the non-eligibility criteria for the central heating programme. (S2O-8856)

Johann Lamont (Labour, Glasgow Pollok)

The definition in question is contained in the Home Energy Efficiency Scheme Amendment (Scotland) Regulations 2001 (SSI 2001/267). We are considering those regulations in their entirety as we develop our new central heating programmes, and we will carefully consider the wording of the definition in that context.

Charlie Gordon (Labour, Glasgow Cathcart)

Does the imminent end of the current phase of the central heating programme afford an opportunity to introduce greater operational discretion, so that, for example, the existence of an old-fashioned storage heater in the hallway of a house will not lead to people being ineligible to benefit from the scheme?

Johann Lamont (Labour, Glasgow Pollok)

Yes. We recognise the programme's significance and success, and we have spent more than £200 million on fuel poverty measures in the period in question. However, inflexibilities and technicalities in the programme that could not have been predicted have been thrown up, often through constituents contacting members, and it has been recognised that the aim of lifting people out of fuel poverty has not been met in certain circumstances as a consequence. I assure the member that in developing and reviewing the process, I am particularly mindful of the small issues that can make a difference to individual constituents and that I will take on board any comments that members have on such issues as we progress.

Christine Grahame (Scottish National Party, South of Scotland)

In that spirit, I remind the minister that 5,000 households with children in Scotland live in fuel poverty and have no central heating. Central heating could be installed in those households at an estimated cost of £1.6 million. In reviewing the regulations, will she take that into account and consider lifting those vulnerable children out of the difficult circumstances in which they live?

Johann Lamont (Labour, Glasgow Pollok)

We are still considering how to take the programme forward. We have already indicated that we intend to extend it to cover over-60s who are on pension credit. Of course, we must be mindful of the target of lifting people out of fuel poverty and the costs of any measures that we want to develop, but we recognise the points that have been made, which have also been forcibly made elsewhere. Those points and suggestions about who should be included in the programme will be taken into account as we move towards taking final decisions.

Sylvia Jackson (Labour, Stirling)

To ask the Scottish Executive what measures and resources it can provide to enable local authorities, communities and individuals to promote effective representations at formal public inquiries into major planning applications, such as for the Beauly to Denny power lines. (S2O-8859)

Johann Lamont (Labour, Glasgow Pollok)

Pre-inquiry meetings are invariably held well in advance of major public local inquiries, and all groups and individuals who have made representations would be invited to those meetings, at which the procedures would be explained and questions would be answered. General guidance on public inquiries is also available on the inquiry reporters unit website or by requesting assistance from the unit's staff. Any announcement about whether a public local inquiry will be held into the Beauly to Denny power line proposal is a matter for the Deputy First Minister and Minister for Enterprise and Lifelong Learning, Nicol Stephen, because the application would be made under the Electricity Act 1989.

Sylvia Jackson (Labour, Stirling)

I thank the minister for that clarification. However, she will be aware of the massive legal fees that are involved when local groups make representations to a public inquiry and the pressures on the budgets of local authorities—particularly on those of small councils, such as Stirling Council in my area, which must set aside nearly £500,000 for putting its case. Will the Executive consider reviewing the procedures for public inquiries in order to reduce the legal bills that fall on local groups and council tax payers?

Johann Lamont (Labour, Glasgow Pollok)

The member will be aware that there is currently no specific funding for local authorities to cover the costs of managing applications. However, an opportunity has been afforded to us by the radical proposals in the Planning etc (Scotland) Bill to consider such matters, to address the issue of resources and the experiences of different groups and to carry out an honest appraisal of the costs and how they can be managed. As we move forward to considering the hierarchy of approaches to proposals, we recognise that we must consider whether fees are commensurate with the work that is involved. We are very keen to be in close dialogue with local authorities and others about how those processes are managed.

Mary Scanlon (Conservative, Highlands and Islands)

Will the upgrading of transmission lines, such as the Beauly to Denny line, be considered under the national planning framework in future to ensure local and parliamentary consideration and scrutiny?

Johann Lamont (Labour, Glasgow Pollok)

As the member is aware, I already said that the proposals will be developed under the Electricity Act 1989 and dealt with by the Minister for Enterprise and Lifelong Learning. That is the current situation. If there is a proposal to change it, that will be explored as the bill progresses through Parliament.

Andrew Arbuckle (Liberal Democrat, Mid Scotland and Fife)

To ask the Scottish Executive when it will announce the next round of PPP funding for education. (S2O-8912)

Robert Brown (Liberal Democrat, Glasgow)

The Scottish Executive is currently supporting schools public-private partnership projects with a capital value of £2.5 billion, which carries a long-term commitment for the duration of the contracts. Further financial support for school building projects is a matter for the next spending review.

Andrew Arbuckle (Liberal Democrat, Mid Scotland and Fife)

When the next spending review comes round, will the minister bear it in mind that the more lead-in time that local authorities can be given to make their decisions, the more efficient their spending will be?

Robert Brown (Liberal Democrat, Glasgow)

I entirely accept Andrew Arbuckle's point. However, the PPP project is a long-term one and we need to be able to spread the contracts—the building work and so forth—over time. The detail, as he rightly says, is a matter for local councils, which are responsible for presenting to us their priorities in that regard. Clearly, priorities have to fit in with spending announcements.

We are dealing with the second tranche of proposals at the moment and they are at various stages of development. There will be progressive implementation throughout Scotland of the current and future spend on those projects.

Fiona Hyslop (Scottish National Party, Lothians)

How many hundreds of millions of pounds have been paid out as excess profits to private financiers as a result of the PPP contracts? Before any future spending commitments are made, will the minister consider adopting the Scottish National Party's proposal for a not-for-profit contract so that we can build more new schools and put smaller class sizes for pupils before excess private profits for financiers?

Robert Brown (Liberal Democrat, Glasgow)

The SNP appears to live in a different world to the rest of us. The reality is that record levels of funding have gone into the school building project through PPP, the schools fund and prudential borrowing. The details of the matter have been debated many times in the chamber. The question whether there are excess profits is another matter into which I do not propose to go today.

It is the Scottish Executive's view that there is substantial advantage to be had from the additional spend that we receive as PPP funding, which has allowed us to do a series of things that did not happen in the education field under previous regimes. That is the essential point as we see school buildings going up all over Scotland.

James (Conservative, Lothians)

Does the minister agree that it is important that local authorities work with PPP providers to ensure that adequate green space is made available in new school campus developments to make absolutely certain that children have access to sufficient informal play and exercise areas?

Robert Brown (Liberal Democrat, Glasgow)

I very much agree. The Scottish Executive gives local authorities guidance in that regard, but I stress that it is up to local authorities to make their own decisions in such matters and to be accountable to their electors for the decisions that they make and the priorities that they set. However, the Scottish Executive supports the importance of green spaces and play facilities.

Elaine Murray (Labour, Dumfries)

To ask the Scottish Executive whether it considers that qualified nursery teachers make a valuable contribution to pre-school education. (S2O-8874)

Peter Peacock (Labour, Highlands and Islands)

The short answer is yes. The Executive has issued guidance on the involvement of teachers in pre-school education that recognises the distinctive contribution that they can make alongside other early years staff.

Elaine Murray (Labour, Dumfries)

The minister will be aware of research undertaken in England and Wales—the effective provision of pre-school education study—that demonstrated that not only did input from nursery staff with graduate-level qualifications improve children's attainment in their later years, but the effect was particularly marked when a staff member was trained in teaching. Does he therefore share my concern that some local authorities, including Dumfries and Galloway Council, have been considering removing teachers from nursery classes as part of the current savings exercise, albeit that councillors have now rejected the most extreme options placed before them by officials?

Peter Peacock (Labour, Highlands and Islands)

The study referred to makes an important contribution to our thinking about the policies on early years. However, I make it clear that when the Executive changed rules in the schools code to allow local authorities more flexibility in deciding whether to deploy teachers in a nursery setting our intention was not to remove teachers from that setting but to provide genuine flexibility, such as allowing a teacher to cover a group of centres in rural areas, rather than work in a single centre.

I hope that I made it clear in evidence to the Education Committee yesterday that we recognise the distinctive dimension that teachers can bring. However, other qualified staff also lend important dimensions to the teaching of young people in the early years setting.

Sandra White (Scottish National Party, Glasgow)

I thank the minister for his truthful answers and hope that Glasgow City Council was also listening to them. He will know about that council's proposals to remove all qualified teachers from nursery schools. By his own admission, it is excellent to have qualified teachers in nursery schools. The curriculum for excellence and the three-to-18 curriculum stress that there should be smooth transitions between educational stages.

Bearing in mind the minister's answers today and his evidence to the Education Committee, will he meet Glasgow City Council and tell it of our concerns, the concerns of the Education Committee and his concerns about the removal of qualified teachers from nursery schools, which is being done to save around £370,000? The proposals are budgetary and are nothing to do with children's welfare.

Peter Peacock (Labour, Highlands and Islands)

I have great respect for Glasgow City Council. It is a progressive education authority that has a range of new ideas about how to develop education in Glasgow, for which it has my support.

The decisions that it might or might not arrive at are very much a matter for Glasgow City Council, but the Executive's policy is clear: although we leave it to local authorities to make such decisions, we recognise that teachers have a particular contribution to make in the early years setting.

Kenneth Macintosh (Labour, Eastwood)

To ask the Scottish Executive whether it will provide further support to help to develop fair trade in Scotland. (S2O-8866)

Patricia Ferguson (Labour, Glasgow Maryhill)

The Scottish Executive is committed to supporting fair trade and has taken a number of steps to support fair trade products. The parliamentary cross-party group on fair trade, which I chair, recently met to discuss appropriate steps for how best to achieve our agenda, and will continue to receive full support from the Executive.

Kenneth Macintosh (Labour, Eastwood)

I thank the minister for the welcome lead that the Executive has shown on fair trade matters. Is she aware of the many areas in Scotland, including East Renfrewshire, that are currently pursuing fair trade status? Will she engage with the fair trade community to explore what further help might be available to those areas—for example, to improve the marketing of fair trade products and the procurement process so that supplies can be delivered more easily to public authorities? In particular, will she consider issuing guidance to public authorities that makes it clear that fair trade sits comfortably alongside the best-value regime in securing the most cost-effective use of public resources?

Patricia Ferguson (Labour, Glasgow Maryhill)

The group that I chair is currently looking at a range of options, one of which is how we achieve fair trade status for Scotland as a country. We will work very closely with the Fairtrade Foundation to develop that work.

We are sure that one of the criteria that we will be expected to meet is that of achieving a critical mass of local authorities, community, church and faith groups and schools to sign up to the fair trade agenda and achieve fair trade status. The work in East Renfrewshire is helpful in that regard.

Guidance is already available to local authorities and other public sector agencies on the use of fair trade products through the procurement process. By coincidence, at this week's meeting of the cross-party group on fair trade, we discussed the possibility of looking at that guidance again to see whether it can be strengthened. We are also considering the possibility of holding a seminar for public sector agencies, perhaps in the autumn, to develop that agenda further.

Mark Ruskell (Green, Mid Scotland and Fife)

Given that a number of us from the Parliament will visit Malawi next week as part of the Commonwealth Parliamentary Association visit, and that we will meet Malawian fair trade sugar and coffee producers, what message should we send and which questions should we put to the Malawians about the prospects of the Scottish public sector buying their products and supporting economic development in that country?

Patricia Ferguson (Labour, Glasgow Maryhill)

Obviously, the Executive is working with the Malawian Government on our co-operation agreement. We intend to take forward that agenda as expeditiously as we can. I would be very grateful if the delegation of which Mark Ruskell is a member could bring us back some information on the projects that he mentioned. If there is a way in which the Executive can assist any of those projects on the ground or in connection with marketing here, for example, we are more than happy to look at the possibilities and to give any assistance that we can.

Duncan McNeil (Labour, Greenock and Inverclyde)

To ask the Scottish Executive how it will help to promote Greenock as a port of call and embarkation for cruise ships. (S2O-8868)

Patricia Ferguson (Labour, Glasgow Maryhill)

Several locations in Scotland, including Greenock, market themselves as cruise liner destinations. VisitScotland has embarked on a research project into the economic impact of cruise tourism. Various ways of marketing the varied attractions of Scotland to potential visitors from cruise ships that call at Scottish ports will be assessed in light of the findings of that study.

Duncan McNeil (Labour, Greenock and Inverclyde)

From her visits to Inverclyde, the minister will be aware of the importance of Greenock Ocean Terminal to the local economy in my constituency. The 22 cruise ships that will call at Greenock this year will bring 30,000 passengers, plus crew, into the area. I hope that they will spend some time and money in the area as well as in other parts of Scotland.

Although the port operator, Clydeport plc, and others continue their efforts to promote Greenock Ocean Terminal, we would be grateful for Executive assistance in one small respect. Will the minister look into the possibility of proper signage being erected, similar to that which exists on the approaching trunk roads for the ferry terminals? That would help to put Greenock Ocean Terminal on the map for visitors and locals.

Patricia Ferguson (Labour, Glasgow Maryhill)

I met many of the people who are involved in the project during my recent visit to Inverclyde with Duncan McNeil. I put on record my thanks to the volunteers who are making the experience of those who embark and disembark at Greenock as pleasurable an experience as it is possible to have. The volunteers are also doing a good job in taking people from the cruise liners around the attractions of Greenock and Inverclyde.

I point out to Mr McNeil that the matter of signage is primarily for the local authority. I agree that the Greenock Ocean Terminal should be adequately signposted and I draw his attention to the "Scottish Road and Motorway Tourist Signposting Policy and Guidance: A Consultation Paper", which the Executive issued at the end of last year. I understand that the consultation period closed last week, but I am sure that any further thoughts that he may have on the matter could be fed into the process and that my colleague Tavish Scott would be interested to hear them.

Murray Tosh (Conservative, West of Scotland)

Question 7 is withdrawn.

Karen Gillon (Labour, Clydesdale)

To ask the Scottish Executive for its response to the view that was expressed by David Watt, head of the Institute of Directors, as reported in the Daily Record , that corporate killing laws were a "witch hunt" against bosses and that most industrial accidents were due to human error at a lower level and more likely to be caused by "alcohol than by individuals acting in a corrupt or homicidal manner". (S2O-8854)

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

The corporate homicide expert group was established to review the law on corporate liability for culpable homicide. Its membership was drawn from a wide range of interest groups, including representatives from the business sector. If organisations take appropriate steps to protect their workers and the public, they have nothing to fear from any reform of the law in this area.

Karen Gillon (Labour, Clydesdale)

I am sure that the minister appreciates the distress that the comments have caused, particularly to the relatives of the Findlay family who died in an explosion in my constituency. The relatives are campaigning for a change in the law on corporate liability for culpable homicide.

The minister is presently considering the views of the expert group. Given the complexity of the issue and the need for mature debate on the subject, how does the Executive intend to move forward on the matter? We need to ensure that such misinformed and ill-judged comments can be put to bed once and for all.

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

I recognise the work that Karen Gillon has done on the issue in representing her constituents and in serving as a member of the expert group. The Executive is considering the recommendations of the expert group. We are also looking at what is happening at United Kingdom level. We will report to the Parliament on the matter in due course.

Following the lodging of Karen Gillon's question, the Institute of Directors has been in touch with me and has provided a further statement. I will ensure that the information that it contains is conveyed to her, as appropriate.

First Minister's Question Time

Nicola Sturgeon (Scottish National Party, Glasgow)

To ask the First Minister when he will next meet the Prime Minister and what issues they will discuss. (S2F-2085)

Jack McConnell (Labour, Motherwell and Wishaw)

I look forward to seeing the Prime Minister soon, and we will discuss issues of importance to Scotland.

I take the opportunity to congratulate members who were involved in last night's danceathon to raise money for Malawi. I understand that they raised about £1,300, all of which will be donated straight to projects in Malawi. They are to be congratulated and I hope that there will be further events in the future.

Nicola Sturgeon (Scottish National Party, Glasgow)

Last night's effort was absolutely tremendous and I am sure that it is great news for the Malawi fund.

I am sure that, like all of us, the First Minister was absolutely horrified at the news earlier this week of the 11-year-old girl in Glasgow who collapsed after using heroin. Does he agree that, after parents and families, schools and teachers are often the first line of defence in the war against child drug abuse? If so, can he explain why national funding for drugs education and teacher training has been withdrawn?

Jack McConnell (Labour, Motherwell and Wishaw)

First, I presume that all of us, from all parties, feel shock at the incident that was reported last weekend. In such circumstances, it is always difficult to talk about the individuals involved, but it is clear that the incident raises issues for us. I hope that we will be able to respond to those issues at the same time as we give support to the school and people affected by the incident.

One of the achievements of recent years has been to ensure that drugs education is available in every school in Scotland. That co-ordinated programme of drugs education has run alongside interventions with young people in the community, the work of the Scottish Drug Enforcement Agency—with the choices for life programme for primary 7 children—and the other efforts that are under way to educate young people and others that heroin in whatever form it is taken is addictive. All those aspects, which all involve additional resource, have been important over the years. In my view, a comprehensive approach to the problem is essential.

Nicola Sturgeon (Scottish National Party, Glasgow)

The First Minister will be aware that since 1999 there have been no fewer than four reports—the most recent of which is from Her Majesty's Inspectorate of Education—calling for better training of teachers in schools so that they can better provide drugs education.

I draw to the First Minister's attention a parliamentary answer given by the Minister for Education and Young People only last week. Is the First Minister aware that, according to that information, all dedicated Government funding for drugs education and awareness in schools and for drugs education training for teachers was withdrawn completely in March 2004? Given recent research showing that 13 per cent of 13-year-olds and 35 per cent of 15-year-olds in Scotland claim to have used drugs, does not that lack of financial commitment to drugs education represent a fundamental flaw in the Executive's drugs policy?

Jack McConnell (Labour, Motherwell and Wishaw)

It was appropriate to have a specific funding allocation when comprehensive drugs education was not available in every school and comprehensive continuing professional development was not available for every teacher—not just in teacher training but throughout their working life—as it is now as a result of the agreement that we reached with teachers' unions and teachers themselves in 2001.

Since then, we have mainstreamed not only continuous training for teachers but the funding. We have ensured that, throughout Scotland, there is available not just an incidental amount of funding for drugs education and an incidental amount of training for teachers to become better drugs educators; we have ensured that councils and schools are able to mainstream the funding and the training to ensure that drugs education is available in every single school.

That is important, but it is also important that we review the situation. Ms Sturgeon might be interested to know that this month we are due to receive the report that we commissioned last year on drugs education in schools—now that the programme is several years on—to ensure that we can learn further lessons and that the programme can be expanded and improved in years to come.

Nicola Sturgeon (Scottish National Party, Glasgow)

That will be the sixth report in six years and, right now, there is still no dedicated funding for drugs education. The First Minister talks about comprehensive education, but I suggest to him that he has no idea what is going on in schools in relation to drugs education. How can he possibly know when the Executive's annual survey that was set up to monitor drugs education in schools has not been carried out since 2003, before the funding was withdrawn? How can he know when, last week, in answer to the question, "How many teachers have been trained in drug awareness and prevention?" the Minister for Education and Young People said that he did not know because the Executive does not collect that information?

Is it not time for the First Minister to admit that not nearly enough is being done to educate kids about the dangers of drugs? Is it not time for him to get his finger out and do a bit more about it?

Jack McConnell (Labour, Motherwell and Wishaw)

I had many differences with Michael Forsyth when he was my local MP in Stirling and when he was the Secretary of State for Scotland. However, one of the things that he achieved in his time as Secretary of State for Scotland was to depoliticise the drugs issue and to ensure that parties and party leaders came together and rose above party-political debate to ensure that concrete action happened in Scotland. That has been the case until today, and I am disappointed that Ms Sturgeon has chosen seriously to misrepresent the situation.

Over the years, the nationalists and many others have consistently called for us to hypothecate less of the local authority budget for education and other matters to give local authorities more choice over how they spend their money in schools and elsewhere. We refuse to do that until we are certain that services are being delivered. Only when we were certain that drug education was available in every school and that teachers were being properly trained before they became teachers and throughout their working lives did we move away from a hypothecated budget and start to mainstream the budget to ensure that local authorities could make decisions at a local level. Our objective was to create an improved service that was better funded. We achieved that and it is wrong to misrepresent the situation.

Ms Sturgeon misrepresents another aspect. What happens in schools is an issue, but so is what happens in the home, and there is an issue of parental responsibility. In the case that has been mentioned, there is also a responsibility among the neighbours of the dealer who was selling heroin to someone of the age of 11. Either they did not spot it or, if they knew about it, they did not report it. There is a responsibility on the parents of the 11-year-old girl and there is a responsibility on us to ensure that we take more prompt action for youngsters who are living with drug-addicted parents and put the interests of the children first, locally and nationally. That is something that we intend to review.

Nicola Sturgeon (Scottish National Party, Glasgow)

I accept that the solution to drug abuse is complex and I agree with the First Minister's latter comments. However, surely there can be no doubt that education is a vital part of the solution. It is not politicising an issue—in this week of all weeks—to say that we should be doing more to educate our children about the dangers of drugs. It beggars belief that, when faced with the increasing use of drugs by children, the Executive's response has been to stop the monitoring of drugs education in schools and funding for it. Does the First Minister agree that it is time for us all to do more to prevent more young children from falling victim to drugs?

Jack McConnell (Labour, Motherwell and Wishaw)

I am sorry, but it is politicising the issue to completely misrepresent and distort the position. Not only is there now training for teachers in advance of their becoming teachers and throughout their working lives and improved funding for education as a whole and for drugs education in particular through schools and other agencies, including the police service and the Scottish Drug Enforcement Agency, which runs the choices for life programme, but we have ensured that drugs education is available in every school in Scotland. We are reviewing that not to have another report, as Ms Sturgeon complains, but to ensure that we improve the situation. I hope that, when we receive the recommendations, we can work on an all-party basis to take them forward.

Education is important in tackling drug abuse, but what happens in the home and in the community is at least equally as important. There is a serious issue in relation to youngsters in homes in which the family is involved in drug abuse and drug addiction. The hopes, opportunities and futures of those youngsters must come first. That is why, while we continue to improve drug education in schools, we will examine seriously what happens in the home and what our social services are doing about it.

Annabel Goldie (Conservative, West of Scotland)

To ask the First Minister what issues will be discussed at the next meeting of the Scottish Executive's Cabinet. (S2F-2086)

Jack McConnell (Labour, Motherwell and Wishaw)

The Cabinet will discuss a wide range of issues, including regeneration and, I suspect, the on-going work on criminal justice, which is a subject that comes up regularly in discussions with Miss Goldie at question time.

Annabel Goldie (Conservative, West of Scotland)

If an 11-year-old girl asked the First Minister about taking heroin, would he give her information that was designed to help her to know the score so that she could decide for herself or would he tell her how dangerous drug abuse is and say that under no circumstances should she experiment with heroin?

Jack McConnell (Labour, Motherwell and Wishaw)

The two things are the same. That is precisely why we are running a national advertising campaign not just on our television screens—I am sure that people will have seen the campaign regularly in the evenings in January—but in our schools and elsewhere.

Appropriately, given what happened last weekend, the particular message for the early part of 2006 has been that smoking heroin is just as addictive as injecting heroin. We were aware that that message was not getting through, particularly to younger people. That is why we supported, with considerable resource, a national advertising campaign to ensure that young people not only know the impact of drugs but are dissuaded from drug abuse by the force of that information.

Annabel Goldie (Conservative, West of Scotland)

This appalling case highlights two simple points: the need for a clear message on drug abuse and the need for that message to be presented effectively. We have neither. Is it not time to ditch the discredited know the score campaign, which is a mocking echo of confusion and failure, and adopt a commonsense message that is designed to prevent our young people from even contemplating taking drugs? Does the First Minister accept that a straightforward, sensible message must be presented in an innovative fashion, not by people such as me and the First Minister but by former addicts and others with first-hand experience of the problem?

Jack McConnell (Labour, Motherwell and Wishaw)

That is precisely the change that we have made, and are making, to the drugs information campaign. The simple message of the past—the just say no approach—is not enough on its own. If we tell youngsters to say no without explaining why, without explaining the range of dangers that exist and without supporting those youngsters in the community by giving them the confidence to say no to their peers or to older people who might try to deal in drugs with them, the message will fail.

Getting youngsters to say no is, of course, the primary objective of our drugs campaign, but at the same time we are ensuring that they have the information to make the right choices and the confidence to say no in a range of different situations and to say to other young people, "Did you know about this? Can you make that choice too?" That is our job and we do it in innovative ways in our schools, through our police forces, through communities, through other young people and through the role models that young people have. I agree that the message should come not from politicians but from people to whom young people will listen. That is why we will continue the effort, step up the campaign and ensure that young people get the message clearly and make the choice to stay away from drugs.

Annabel Goldie (Conservative, West of Scotland)

The trouble is that young people are not saying no. The number of under-15s who have been treated for drug abuse has more than doubled since the introduction of the know the score campaign, so the recent case is not an isolated incident. We need a strong anti-drugs message now. It must be straightforward, unequivocal, clear and commonsense. If the First Minister will not listen to me, will he listen to his Labour colleague on Glasgow City Council, Gaille McCann, who believes that this desperate incident should

"act as a wake-up call to us all, particularly the policymakers in their ivory towers"?

Jack McConnell (Labour, Motherwell and Wishaw)

I think that that is true and I will return to that point, but it is also important to note that, when there is an increase in the number of people who are getting treatment, it is sometimes because they are coming forward and being identified. The treatment services are available because of the additional investment that we are putting into them. I understand that, currently, 418 young people under 16 are entering treatment. That is good because, otherwise, those 418 youngsters would be out on the street taking drugs and, perhaps, encouraging others to do the same. We need to have a comprehensive approach.

I agree with the point about looking at the policies and the way in which we respond. We know that youngsters who are in the homes of drug-addicted parents are more likely to get involved in drugs. That has become a fundamental issue for us. How do social services and other services respond to such situations? The needs of the children must come first and be considered when they are at a very young age. There should be a review of how our social services and others respond to ensure that youngsters have the best possible chance in life.

Murray Tosh (Conservative, West of Scotland)

There are two constituency questions.

Frank McAveety (Labour, Glasgow Shettleston)

I welcome the First Minister's comments, particularly about the role of social services. The case that has been mentioned has shocked the east end of Glasgow as much as it has shocked the rest of Scotland.

My concern is to ensure that we support schools. I ask the First Minister to demonstrate that we give that support through the allocation of resources for drugs education to ensure that communities are not as badly affected as they have been by this case. Therefore, will the First Minister indicate what resources are presently available and what procedures are in place to ensure that we support children and give cities such as Glasgow enough resources to tackle the problem of drug misuse?

Jack McConnell (Labour, Motherwell and Wishaw)

Mr McAveety will be aware that the Minister for Education and Young People recently announced increased resources for the city of Glasgow and other areas with particular problems. I hope that that will be supported throughout the chamber as we tackle these difficult issues.

From my earlier exchange with Ms Sturgeon, Mr McAveety will also be aware not only that there are increased resources for schools, but that there is drugs education in every school and that we have the required back-up and support for that from the community. I understand that, in Glasgow alone, 10 specific projects on alcohol and drug abuse are funded by our changing children's services fund, working in the areas of the city that most require such assistance. Ultimately, the state and schools can do so much, but families, neighbours, friends and others in the community also have a role to play.

If there is going to be a truly national effort, we need to ensure that our policies are appropriate and effective and intervene at the right time. We must also ensure that people identify the problems for us by being active in the community and reporting incidents. That is why we have used the money that we have taken from drug dealers, following their court case, to run local campaigns and to get local people to identify dealers so that we can convict more of them and stop this abuse happening in communities across Scotland.

Rob Gibson (Scottish National Party, Highlands and Islands)

Is the First Minister aware of the widely rumoured £3.5 million deficit in the books of the Western Isles NHS Board, which comes on top of the shock news earlier this week that a senior clinician with 24 years service in the islands has been sacked for whistle-blowing over allegations of bullying made by senior staff against the board chairman and chief executive? Will the First Minister insist that his Minister for Health and Community Care, Andy Kerr, takes heed of widespread local opinion, including that of Western Isles Council, and uses powers of intervention under the National Health Service Reform (Scotland) Act 2004 to restore quickly to the outer isles a health service that is based on trust and harmony and that can spend its scarce funds on patient services rather than protracted staff grievance procedures?

Jack McConnell (Labour, Motherwell and Wishaw)

It would be totally inappropriate for a Government minister to intervene in an individual employment case in relation to which proceedings have not yet been completed. In such situations, whether in the health service or anywhere else, it is right and proper that individuals who have been the subject of disciplinary action by their employer should be able to follow the correct procedures, go through the appeals and thereby have their case heard.

I recall that, fairly recently, there were calls for ministers to intervene in an individual disciplinary case following an incident at either Inverness College or the university of the Highlands and Islands. However, the case was resolved by going through the proper procedures, which was the right way for that to go. I do not think that it would be right for ministers to intervene in this case.

Colin Fox (SSP, Lothians)

To ask the First Minister whether the Scottish Executive will safeguard the right of Scotland's public sector workers to retire at 60 under the rule of 85 regarding age and years of service. (S2F-2102)

Jack McConnell (Labour, Motherwell and Wishaw)

Any member of the local government pension scheme has the right to retire at 60 if they choose, and there are no plans to change that. However, the rule of 85 allows only those members who qualify to do so with an unreduced pension.

Colin Fox (SSP, Lothians)

That answer completely contradicts the answer that the Minister for Finance and Public Service Reform gave to an earlier question. Hundreds of thousands of public sector workers in Scotland are furious at the Scottish Executive's attempts to withdraw their pension rights. Is it not the case that the legal advice that the Executive quoted was completely contradicted by the advice of both the Convention of Scottish Local Authorities and Unison, as well as by the advice of the European Commission spokesperson on employment, Katharina von Schnurbein, who ruled that

"The directive has no influence on pension value or pension age. It is completely up to the member state. If they think it is reasonable for people to retire at 60, under EU law that is perfectly legal"?

Will the First Minister assure us that he intends to protect the right of Scotland's council workers to retire at 60?

Jack McConnell (Labour, Motherwell and Wishaw)

As I said, any member of the local government pension scheme has the right to retire at 60 if they choose to do so, and there are no plans to change that. There are plans to change the rule of 85, but negotiations about how that will impact on individual members of staff who currently work for local authorities in Scotland are still continuing. It is right that those discussions continue. I make it clear that any attempt by Colin Fox or others to distort the picture should not be believed.

Colin Fox (SSP, Lothians)

I ask the First Minister, therefore, to allay the fears of more than 200,000 local government workers, including carers and teacher assistants, who fear that the Scottish Executive is simply playing its part in sending a signal as part of a wider attack on pensions that will see employees across the country asked to pay in more, work longer and receive far smaller pensions when they retire. Will he assure us that that is not part of the plan that he has announced?

Jack McConnell (Labour, Motherwell and Wishaw)

It is important to remember two things. First, we have a duty to obey the law. Although we may from time to time receive calls from at least three of the Opposition parties to disobey the law, we are not prepared to do that—on fishing, on some of the issues that the nationalists raise or on the issues in respect of which Colin Fox and others regularly call on us to disobey the law. We should not disobey the law. We should implement the law under our duty as Government ministers and as a Parliament, and we intend to do so.

Secondly, we intend to look after the public purse, and we need to ensure that, while obeying the law, we have a mind to the cost of the local authority pension scheme. We are ensuring that that happens, and there will be proper negotiations with those responsible on the impact of the change on individual members of staff.

Charlie Gordon (Labour, Glasgow Cathcart)

To ask the First Minister how its "Action Plan on Tackling Sectarianism in Scotland" will involve all sections of the community in the drive against sectarianism. (S2F-2090)

Jack McConnell (Labour, Motherwell and Wishaw)

Community-led action will have an increasing impact in stamping out bigoted attitudes, and I am proud of the way in which Scots have risen to the challenge of defeating sectarianism. The 18-point action plan that I announced on Monday represents a national effort to work with schools, universities and colleges, football clubs, churches, marching organisations, the police and many other stakeholders to achieve that goal.

Charlie Gordon (Labour, Glasgow Cathcart)

Is the First Minister aware of the good work that is currently being done in Glasgow by Glasgow City Council, by the sense over sectarianism campaign and by schools such as St Mirin's Primary School and Croftfoot Primary School in my constituency?

Jack McConnell (Labour, Motherwell and Wishaw)

The sense over sectarianism campaign and a number of other organisations working in that area have done a tremendous job in recent years, not only to raise the issue in the community and to ensure that schools and other organisations receive support but to put pressure on politicians to respond, as I believe we have now done. The work that is going on in Glasgow schools, particularly in the schools where I met pupils on Monday, at St Mirin's and Croftfoot, is outstanding. The youngsters whom I met on Monday were inspiring. I believe that the coming together of those youngsters for a variety of different activities, including reading, visits to other centres, drama and other activities, will have a lasting impression on them for the rest of their lives. I congratulate the teachers involved and I certainly encourage the youngsters to keep up the new friendships that they have made and to ensure that they continue to educate the adults in their lives, as some of them are clearly doing, into their secondary school years and beyond.

Donald Gorrie (Liberal Democrat, Central Scotland)

Will the First Minister ensure that all the organisations that are keen to combat sectarianism feel genuinely involved in the action plan and that it is not perceived as some Government thing that they have to trail along with? In particular, will he ensure that contact is made with the great majority of decent people in many organisations who will help to combat the small minority of extreme fanatics who cause much of the trouble?

Jack McConnell (Labour, Motherwell and Wishaw)

I agree with Donald Gorrie on both his points. There have, indeed, been discussions with a wide variety of organisations over the past year, since the summit that was held last February. I was disappointed to hear the comments last weekend of some people who felt that they had not been informed or involved enough. There certainly has been involvement, but I am delighted to know that people want more involvement and more information. We will certainly ensure that we step up our efforts in that regard over the weeks and months ahead.

Patrick Harvie (Green, Glasgow)

I certainly welcome the proposal in the action plan on the twinning of schools to encourage shared activities and to help to overcome the barriers that exist between communities. Such things are happening in some areas already. However, surely it would be better not to put up those barriers in the first place. Is it not time for the First Minister to clear the path towards full integration in our education system? If he is not able to take that position at this time, will he at least agree that the creation of new religious dividing lines in our school system would be a step in the wrong direction?

Jack McConnell (Labour, Motherwell and Wishaw)

I do not agree with the abolition of Roman Catholic schools in Scotland. We need only look across the border to England to see a wide variety of schools of different faiths. The youngsters who attend those schools do not hate other religions.

Sectarianism in Scotland does not come from the schools; it comes from history, tradition, families and sometimes the communities in which youngsters grow up. Our job here is to ensure that, through the school system, youngsters are brought together whatever school they attend; that, through the force of the law, we tackle those who abuse others in the community as a result of a religious divide; that we manage and make decisions on marches and parades more effectively and with more determination to stamp out violence and abuse in the years to come; and that we work closely with all our religious leaders—including the Moderator of the General Assembly of the Church of Scotland, who I see is with us today, and others who have supported these efforts—to bring together people of different faiths, so that they understand each other more, tolerate each other's views more and, at the end of the day, create a far more happy and inclusive Scotland.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

To ask the First Minister what action the Scottish Executive has undertaken in response to the findings published in 2003 by Professor McKeganey, which examined the extent of drug use and exposure in 10 to 12-year-olds. (S2F-2103)

Jack McConnell (Labour, Motherwell and Wishaw)

I have every sympathy with Stewart Stevenson. He has a record of raising these issues and today he has had to follow on from earlier questions. I acknowledge the particular problem in his constituency and his interest in the issues. I hope that we can continue to work together on them.

As I said earlier, we are taking action on a number of fronts. We are ensuring that there is drugs education available in all schools; a national public information campaign; early intervention and diversionary programmes for youngsters and families; and improved treatment for those with acute problems.

Stewart Stevenson (Scottish National Party, Banff and Buchan)

I take the opportunity of saying that the First Minister will have a faithful friend for any sensible initiatives to which we can all sign up. However, the signs are not encouraging. I have been asking questions for around three months about what we know of these issues. The First Minister will know that Professor McKeganey's report was commissioned not in Scotland but by the Home Office—it was not a Scottish report.

In written answers on 3 November and 18 November, I was told that we do not know the size of the drugs trade and that we do not work with the Home Office. We do not have a report such as the one produced annually in London that gives information on the size of the drugs trade south of the border, on how many people are using different drugs, and on what the impact of those drugs is. Is it not time that we had quality research into factual ways of determining policy in Scotland—research that is at least as good as what is available south of the border?

Jack McConnell (Labour, Motherwell and Wishaw)

It is vital that our approach covers all the different areas in which we must have an impact through policy, funding and the other decisions that we make. We do that not by reference to the Home Office but by reference to what is happening here in Scotland.

If Mr Stevenson indeed watches the matter carefully, he will see that in certain areas the Home Office and the United Kingdom Government are learning from what is happening in Scotland. That is good, and such an approach helps us because drug dealers do not exist in either Scotland or England but move across the border.

Aside from Professor McKeganey's report, the report entitled "Hidden Harm: Responding to the needs of children of problem drug users", on which an action plan will be published this spring, was also produced in 2003. We know from that report, and from the widespread consultations that are important if we want to bring together everyone who works in the drugs field, that we need to improve drugs education in every school in Scotland and that not only the police but—critically—our Scottish Drug Enforcement Agency must take certain educational and enforcement measures. Indeed, the Parliament will debate this afternoon the creation of an agency with wider powers, among other issues. Furthermore, we need to ensure that the money that we retrieve from dealers through convictions is reinvested in the community to tackle any damage that has been caused.

Evidence has shown that those actions must be taken, and the changes and adaptations in policy, the new laws that have been created and the new funding that has been allocated in recent years have all been based on that reality. We will continue to do those things and more.

Mary Scanlon (Conservative, Highlands and Islands)

To ask the First Minister whether the Scottish Executive will consider introducing regular NHS health checks. (S2F-2093)

Jack McConnell (Labour, Motherwell and Wishaw)

We are committed to a national health service that responds to people's health needs throughout their lives and, indeed, have already adopted a strategy of targeted health checks for those who are most at risk from disease.

Mary Scanlon (Conservative, Highlands and Islands)

If the Executive is considering the introduction of NHS health checks, why was the annual health check for the over-75s, which was introduced by the Tories, dropped in the new general practitioner contract?

Jack McConnell (Labour, Motherwell and Wishaw)

I was going to be kind to Mary Scanlon, because I think her interest in the matter is genuine, but I cannot resist reminding her of what happened to the change that the Tories made. The GP contract was amended in 1990 by the then minister with responsibility for health, Mr Michael Forsyth, to include a health check for patients who had not been seen by a GP for three years. However, the introduction of the measure was such a shambles and the programme was so badly organised, implemented and monitored that the Conservative Government dropped it in 1993.

Our current commitment to health checks is very important. In Scotland, we will quite rightly begin by targeting checks at those who need them most. Indeed, that is the rationale behind not only the health checks but the prevention 2010 programme that the Minister for Finance and Public Service Reform announced in response to the report by Professor David Kerr—the other Kerr—in the autumn. That preventive approach will not only ensure that our health service is more effective but save lives.

Murray Tosh (Conservative, West of Scotland)

That concludes questions to the First Minister.

Question Time — Scottish Executive — Health and Community Care

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

To ask the Scottish Executive how it will protect services for older people in remote parts of Scotland provided by centres such as the Assynt centre in Lochinver and the Cala Sona in Melness. (S2O-8909)

Lewis Macdonald (Labour, Aberdeen Central)

It is for individual local authorities to determine what level of provision is required to meet the needs of older people and to arrange an appropriate range of services. In the current financial year, we have provided councils with £1.6 billion to support their provision of community care services.

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

The deputy minister will be aware that, during the past hour, Highland Council has, thankfully, decided to put on hold the proposal to shut the Assynt centre in several months' time. Does he agree that the upset and distress for local people has been colossal, that the issue has not been handled as well as it could have been and that the council's decision is just a holding move? Will he ask his officials to look into what has happened and into the possibility of maintaining for the long term that important centre in a remote part of the Highlands, where we desperately need respite beds and where distance is a huge issue?

Lewis Macdonald (Labour, Aberdeen Central)

Jamie Stone rightly alluded to the fact that my officials are in touch with Highland Council on that and a range of related matters. However, it is important to be clear that it is not for ministers or officials to tell councils how they should make best use of the resources with which we provide them. We are clear about the importance of appropriate services being available to people where they can access them. Clearly, those services need to meet given standards, which are set by the Scottish ministers. We look to local authorities to ensure that, whatever range of services they provide in order to meet the needs of people in those positions, they do so in a way that meets those standards. Jamie Stone referred to the importance of respite; again, that is well understood and is reflected in the guidance that we give to local authorities.

Rob Gibson (Scottish National Party, Highlands and Islands)

I wonder, from what the minister says, whether he understands how difficult it is in small communities to maintain the jobs that can flow from having care homes? It is essential in the Highland area, where a third of the beds for care homes are provided by the council, that we maintain jobs that support local people—in small communities such as Assynt—and that we have a policy of moving forward. He said that he gave councils £1.6 billion for the provision of community care services. Can he build into that some element for remote communities to encourage the expansion of small care homes?

Lewis Macdonald (Labour, Aberdeen Central)

It is important to be clear about the direction of policy, which is not to encourage more people to be resident in care homes but to enable more people to stay in their own homes. I know from Jamie Stone's and Rob Gibson's questions that they appreciate the importance of people having access to services close to home. That is our intention too. However, it would not be appropriate for Government to dictate to councils whether sheltered housing, care homes or other forms of support are most appropriate in the circumstances. That is for councils to decide; they are elected and are therefore accountable.

Nanette Milne (Conservative, North East Scotland)

It has come to my notice that Lorn and Islands district general hospital and, as far as I can make out, other hospitals in Argyll and Bute, have been unable to refer anyone for home care packages for free personal care since November. Since Christmas, there have been no referrals to nursing homes because there is no money. Will the minister confirm that? If that is the case, does it not make a mockery of the Executive's principles of free personal care for the elderly, and independence and choice for elderly people?

Lewis Macdonald (Labour, Aberdeen Central)

I cannot confirm the details that Nanette Milne has provided to the chamber, but I am aware of issues around the funding of free personal care and how councils carry out their responsibilities in that regard. We are working closely with the Convention of Scottish Local Authorities to ensure that there is a better understanding around the table of the funds that are provided and the purpose for which they are provided, and to ensure that they are properly spent. The policy position is clear: an entitlement to free, personal care in the circumstances that have been described.

Eleanor Scott (Green, Highlands and Islands)

I appreciate what the minister says about this being a decision for local authorities and the tendency to emphasise the need to keep people in their homes and provide the appropriate care for that. However, does he agree in principle that, given our increasing frail and elderly population, we need a spectrum of care in all communities that will include residential and respite care as well as home care?

Lewis Macdonald (Labour, Aberdeen Central)

I agree with the principle that Eleanor Scott enunciates. That is the principle that underlies "Delivering for Health", which Andy Kerr announced to the Parliament a few weeks ago. Making a spectrum of care available in communities is the right way forward. We will look to our delivery agencies to deliver that in the most appropriate way in their local areas.

Mark Ruskell (Green, Mid Scotland and Fife)

To ask the Scottish Executive how NHS Scotland will contribute to sustainable development. (S2O-8920)

Lewis Macdonald (Labour, Aberdeen Central)

The NHS in Scotland will continue to work towards further significant reductions in its consumption of energy and water, in carbon dioxide emissions and in volumes of waste sent for disposal. We are currently updating NHS Scotland's environmental policy, and NHS boards are making good use of NHS Scotland's computerised environmental management system, as are others in the health care, retail and manufacturing sectors throughout the United Kingdom.

Mark Ruskell (Green, Mid Scotland and Fife)

I welcome the minister's commitment to reducing the direct impact that the NHS has on the environment and on resource use. Can he tell us how the NHS will play a more fundamental role in, for example, developing an indicator for the overall well-being of the nation? Is that something that the Executive is pushing on, which we will see in the future?

Lewis Macdonald (Labour, Aberdeen Central)

The direction of our policy is to recognise both the impacts of the environment on health and the role that the health service plays in the environment. If that is the direction in which the member is inviting me to go, I am happy to confirm that we endorse that cross-cutting approach. Indeed, our officials on the environment side are working together in precisely those areas.

Michael McMahon (Labour, Hamilton North and Bellshill)

To ask the Scottish Executive what action is being taken to encourage school leavers and students to consider nursing as a profession. (S2O-8867)

Andy Kerr (Labour, East Kilbride)

The Health Department is pursuing several initiatives on behalf of the health service in Scotland that will enable health boards to improve recruitment and retention. The careers for health team within the Health Department is leading on a number of initiatives to increase public interest in health-related careers that include nursing and midwifery.

Michael McMahon (Labour, Hamilton North and Bellshill)

I thank the minister for his efforts in encouraging young people to enter nursing as a profession. However, I advise him of the other side of the argument, which was brought to me by four students at one of my local high schools. They informed me of their visit to an open day at Glasgow Caledonian University. They went along to show their interest in a nursing career but were advised that two thirds of the places on the course for the forthcoming year were reserved for mature students. Where does that type of policy fit in with encouraging young people to become student nurses?

Andy Kerr (Labour, East Kilbride)

It does not. I would be interested in taking up that matter with the member, as what he says gives me some concern about the implementation of that policy. It also runs counter to many things that we are involved in—for instance, the creation of an online virtual hospital, using games technology, that enables school pupils and the public to experience and learn about health care careers. That is one of many initiatives in which we are involved that is targeted at young people. We also attend national careers and recruitment fairs throughout Scotland to try to encourage folk into the NHS family. I find what the member says surprising, and I am happy to consider the individual case that he has raised.

Shona Robison (Scottish National Party, Dundee East)

Does the minister agree that pay and conditions are important in encouraging school leavers and students to consider nursing as a profession? Will he respond to the concerns that are being raised by staff and unions about delays in the implementation of agenda for change? Can he reassure us that the May deadline, to which he has referred previously, will be met and that health boards will have the necessary resources to implement agenda for change?

Andy Kerr (Labour, East Kilbride)

The agenda for change exercise has been a huge one for the NHS in Scotland. It involves Scotland's biggest work force and represents a major change in the terms and conditions of those who work in the NHS. It was subject to individual interrogation at every review that I carried out during the summer. I implemented several steps that ensured that enough resources were put into the local agenda for change process. I value that; the deal is clearly important not only to those involved, but in what it delivers for patients in ensuring that we have a more flexible and better trained staff that will deliver our health services in the future. This undertaking is huge and I have said to boards— and I maintain this position—that I want to implement agenda for change as quickly as possible.

However, two things are vital. First is the quality of the process. I do not want to rush the job and end up with an unwieldy number of appeals. Secondly, if the job is rushed, the very people whom we seek to support—our employees—may lose confidence in the process. A balance must be struck. I share the member's concern about the delay, but I have made it absolutely clear to health board chairs and everyone who is involved that we must deliver agenda for change. At my last meeting with those chairs, it was clear that we are beginning to make substantial progress. I take the point, I understand the concerns, and I want to deliver an NHS workforce that is fit for purpose. Agenda for change is integral to that.

John Farquhar Munro (Liberal Democrat, Ross, Skye and Inverness West)

To ask the Scottish Executive whether it has any plans to regulate the cost of parking charges at hospitals. (S2O-8911)

Andy Kerr (Labour, East Kilbride)

Guidance on car park charging on NHS sites was issued to NHS Scotland in April 2004. That guidance is designed to manage better the use of limited parking facilities, discourage unauthorised parking and improve the security of car parking. Therefore the Scottish Executive has no plans to regulate the cost of parking charges at hospitals.

John Farquhar Munro (Liberal Democrat, Ross, Skye and Inverness West)

I hope that the minister appreciates the problem that hospital car parking creates for families who several times a day visit their relatives in hospital. I suggest that Scotland's health boards offer free permit parking for qualified and registered families, and I hope that he will encourage that.

Andy Kerr (Labour, East Kilbride)

That opportunity is already in the guidelines. However, we must be clear. It does not make sense for the Executive to centrally determine what those charges might be and how those systems might work. There are many health care facilities around Scotland, but public transport arrangements for each are different, as are the availability of public parking on streets and other places, the availability of land for parking and indeed council policies. Fly parking is a big issue in certain parts of Scotland—people inappropriately use our health service parking facilities. Although I do not wish to drive that from the centre, because those are local issues, any parking scheme should be not about profit but about improving parking facilities for users. NHS boards can have the arrangement to which the member refers.

Murray Tosh (Conservative, West of Scotland)

I call Kenny MacAskill at this point, and withdraw question 7.

Kenny MacAskill (Scottish National Party, Lothians)

Is there a proposal to improve the availability of access by public transport? Will steps be taken to provide financial support for that, given that many hospitals are now being built on out-of-town sites and are difficult to access without a car? As John Farquhar Munro clearly said, hospital car parking has an impact not only on staff and patients, but on visitors.

Andy Kerr (Labour, East Kilbride)

I take the point seriously, and I have been working on it. The Minister for Transport and Telecommunications and I have met, and we correspond regularly on the matter. I have made this issue clear to NHS board planners. There are good examples of green travel plans and public transport travel plans. For instance, I saw recently the work that is going on in Tayside. However, such work is not widespread enough.

When we survey public opinion on the health service, one top-line message from patients, their families and users of the service is that parking, access and public transport are issues. Therefore we will continue to work as we have been on green travel plans and to invest in better signage and better availability of public transport to our hospitals. Nonetheless, I accept that we can do more, and that is why my discussions with the Minister for Transport and Telecommunications are on-going.

We have also developed some local projects, such as that in Rutherglen in Glasgow, on which we work with patients and their families to improve access. I accept the member's point; access is not what it should be, but he can rest assured that we are working on it.

Murray Tosh (Conservative, West of Scotland)

Question 5 is withdrawn.

Marilyn Livingstone (Labour, Kirkcaldy)

To ask the Scottish Executive what communication it has had with the University of Dundee in respect of the impact on the recruitment of nurses and midwives of the proposed relocation of nursing and midwifery training from Kirkcaldy to Dundee. (S2O-8861)

Andy Kerr (Labour, East Kilbride)

Decisions about where and how pre-registration nursing and midwifery programmes are provided are a matter for the higher education institutions that deliver them, in consultation with all other stakeholders including NHS Scotland.

The University of Dundee notified the Executive of its intention to consult stakeholders about a proposal to relocate the theoretical element of pre-registration nursing education from Kirkcaldy to its main campus in Dundee. Under the proposal, Fife students will continue to undertake the clinical practice element, which comprises 50 per cent of the programme, in Fife. I sought an assurance that, before any decisions are made, the university will undertake a demonstrably robust and comprehensive consultation with staff, students and key stakeholders and discuss the outcome with the chief nursing officer at the Scottish Executive Health Department.

Marilyn Livingstone (Labour, Kirkcaldy)

The minister will be aware that the university's contract for the provision of nursing and midwifery education was awarded in 1996. First, will he inform me how long the contract has to run and whether the proposed changes comply with the spirit of the contract? Secondly, is he aware of the serious concerns that stakeholders have expressed about the impact that the changes will have on nurse and midwife recruitment in Fife, particularly from mature students?

Andy Kerr (Labour, East Kilbride)

I am aware—because the member has made me aware—of some of the concerns about the matter in Fife. Of course, the purpose of the consultation exercise that the university is undertaking is to consider those concerns. We want to ensure that we retain all our existing students so that they go on to work within NHS Scotland. Any student loss would be a tragedy for the service. We must also ensure that their education experience is valuable and appropriate.

As I understand it, the university's proposal will allow the theoretical element of the programme to take place in a new, purpose-built facility. I am not saying whether that is right or wrong—that is a matter for the consultation. I understand that Fife students currently undertake the theoretical element in an older building that is thought to be becoming unfit for purpose, but, again, that is a matter for the consultation. No decision has been taken and no decision will be taken until the consultation process has been completed. In my view, the matter is about investment in the training and skills agenda, valuing our students and making sure that we retain them within the service.

On the member's first point, the contract was renewed recently. I will come back to the member about the precise timescale of the contract as and when appropriate.

Margaret Smith (Liberal Democrat, Edinburgh West)

To ask the Scottish Executive whether it has any concerns regarding the waiting times for the assessment and provision of adult wheelchair services. (S2O-8915)

Lewis Macdonald (Labour, Aberdeen Central)

We do have such concerns. As a result, we allocated £1.9 million of interim funding to the wheelchair service to help to reduce waiting times during the current financial year. We set wheelchair centres a target that 80 per cent of adults should wait no more than 26 weeks from their referral to the time when they leave the centre with the appropriate equipment to meet their clinical need. All five wheelchair centres in Scotland are currently meeting that target.

Margaret Smith (Liberal Democrat, Edinburgh West)

I raise the issue today on behalf of an 18-year-old constituent who has a degenerative condition that means that his wheelchair needs are subject to frequent change. His experience of the service is not quite what the minister described. He has been told that he will have to wait 11 months for an assessment of his wheelchair needs. He has also been told by those who provide the service in NHS Lothian that patients are becoming bedridden because they are having to wait. Some patients have been bedridden for six months. I accept that the minister is trying to do what he can, but does he think that the review that is being undertaken and the extra money that has been provided can be put to good use in improving the unacceptable waiting times?