After section 9

Community Care and Health (Scotland) Bill: Stage 3 – in the Scottish Parliament at 3:00 pm on 6th February 2002.

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Photo of Murray Tosh Murray Tosh Conservative 3:00 pm, 6th February 2002

Amendment 19, in the name of Janis Hughes, is grouped with amendments 19A, 19B, 19C, 19D, 19E, 19F and 19G.

Photo of Janis Hughes Janis Hughes Labour

Amendment 19 seeks to address an omission in the bill with regard to the identification of carers. After hearing powerful evidence at stage 1, the Health and Community Care Committee was persuaded that identification and recognition of carers was lacking in the bill. In the stage 1 debate, I spoke about the evidence from, amongst others, Carers Scotland and in particular from my constituent Isobel Allan. After discussion, the bill was amended to take account of local authorities identifying carers and providing them with information and assistance. However, no such onus was placed on health boards. I lodged an amendment at stage 2 to address that and the Executive agreed to consider the matter prior to stage 3. In the meantime, I was not comforted by words from the Executive and decided that I had to lodge an amendment at stage 3.

The Executive has recognised the role that general practitioners in particular can play in identifying carers and offering them information. I am further convinced of that by several key initiatives across the country, such as the practice accreditation scheme. However, although good practice will always be out there, we must ensure that all carers are offered the same provisions, regardless of where they live and what local schemes are in place. That is why I am keen to see enshrined in legislation a duty on all health board services to identify carers. The GP or practice staff are often the only contact with the carer, so they are in a prime position to identify the carer's needs.

Recently, I have become aware of the valuable work that is being done in that respect by the Princess Royal Trust for Carers, which works with a range of GP practices across Scotland. So far, the trust has identified more than 6,000 hidden carers who might otherwise not have been identified. Another example of the work of the Princess Royal Trust for Carers is its collaboration with the Royal Pharmaceutical Society in pilot schemes to place information in prescription bags to help identify and inform carers. That demonstrates that there is willingness—on the part of carers organisations and the Executive, too—to seek out those who care and to provide them with the assistance that they desperately need and deserve.

I have made my views clear and I know that the rest of the Health and Community Care Committee share my views as set out in amendment 19. The important point for the carers organisations that made representations to us is the need for health boards to have parity with local authorities. We have recognised that local authorities have a duty to recognise and identify carers and to provide them with information, and we think that it is necessary to put the same onus on health services.

I recognise that the Executive's manuscript amendments, although they are not exactly what we had planned, will be a step forward. However, what I have heard so far from the minister today does not convince me that we will actually be providing the carers in our communities with the service that they deserve. I want to hear much more from the minister before we come to a conclusion. I hope that the minister will address the points that I have raised.

On behalf of carers across Scotland, I move amendment 19.

Photo of Mary Mulligan Mary Mulligan Labour

I am grateful to Janis Hughes for explaining so clearly her reason for lodging amendment 19. During the course of the bill, we have discussed at length how carers can be supported better, and in particular, the role that the NHS can play. I have already made it clear that the Executive is committed to working with the NHS to ensure that carers are recognised and supported.

I have also made clear our belief that staff throughout the NHS are working hard, in a wide range of ways, to improve the ways in which they help carers. I mentioned some of those ways in our discussions on amendment 18. Examples are the involvement of GP practices in initiatives to identify and offer information to carers; the developing professional standards for GPs; the overarching development of clinical standards that affect every aspect of health care services; and the development of new, single, shared-assessment processes.

It is clear that the NHS is committed to playing its part in looking out for carers. Across the health service, carers and their needs are on the agenda and we are already engaging with the NHS to raise them further up that agenda. However, it is also clear that there is a strong view that legislation is needed to underpin and complement what the NHS is already doing. The Executive recognises that concern and is willing to help achieve that underpinning. Amendment 19 is intended to deliver that objective. However, we believe that the amendment has a number of flaws that need to be remedied before it can become law.

We have therefore lodged amendments 19A to 19G, which are designed to ensure that amendment 19 translates into clear and workable law that will make a practical difference to the carers.

Presiding Officer, I should like to apologise to the Parliament for lodging amendments 19A to 19G so late in the day. We recognise the extent of the support for a statutory duty of some kind on the NHS, but we believe that amendment 19, as lodged, has serious technical and policy flaws. Rather than rejecting the amendment on those grounds, we believe it is better to lodge amendments to make amendment 19 workable and acceptable. I hope that the Parliament will accept amendments 19A to 19G in the constructive spirit in which they are offered.

I emphasise that it is not the Executive's intention to use the recent changes to standing orders to lodge manuscript amendments at stage 3 regularly. I hope that manuscript amendments will be the exception rather than the rule, but in this case, they are justified. Indeed, I suspect that the changes to standing orders were intended for such a scenario.

Amendments 19A to 19G are intended to amend amendment 19 to achieve a number of things. Our amendments make clear which carers a health board is expected to inform—that is, those carers who appear to the health board to qualify for assessment. That will make amendment 19 consistent with other references to carers in the bill, and with other legislation. Importantly, it will also ensure that health boards target their efforts to those carers who are likely to have the greatest need for support.

The Executive amendments also substitute the word "information" for "identification". The objective of amendment 19 is that health boards should give information to carers with whom they have contact. The substitution gives practical effect to that key objective. It should be clear that we wish health boards to have a duty towards carers with whom they are in contact, and that we are not asking health boards to seek out or find carers with whom they are otherwise not in contact.

Amendments 19A to 19G enable ministers to specify to health boards the extent of their strategies. That will enable ministers to allow boards to minimise duplication of effort with local authorities and other agencies that are involved in supporting carers. Without that change, there is a risk that health boards could end up duplicating work that has already been done by local authorities and others. I am sure that members will agree that that would be a waste of precious NHS resources, which we have to prevent.

We believe that all our amendments 19A to 19G are necessary to allow amendment 19 to become good law that works and makes sense in practice. I have explained the purpose of the amendments and the improvements that they will make, and I ask members to vote for them. However, I make it clear that the Executive will not be able to support amendment 19 if amendments 19A to 19G are not accepted. Without the changes, amendment 19 will not be sufficiently clear and will not translate into good law and practice that helps carers. I hope that what I have said makes it clear why the Executive would not support amendment 19.

I finish by reminding members of how much is happening throughout the NHS to better support Scotland's carers. I have made it clear that staff across the full range of NHS services are working hard, with real results, to improve the ways in which the health service supports carers. That work—with GPs and other health professionals, through clinical standards, and in a range of other ways—is firmly embedded in the way that the NHS works, and will carry on delivering results for carers. We will ensure that carers continue to be directly and closely involved in all that work. Carers are already on the NHS's agenda.

Photo of Mary Mulligan Mary Mulligan Labour

I am just finishing.

I am convinced that the health service is changing in ways that will bring the real and lasting results for carers that we all want to see. I urge the Parliament to support amendments 19A to 19G, and to support amendment 19, as amended by those amendments.

I move amendment 19A.

Photo of Shona Robison Shona Robison Scottish National Party

Given that amendment 18 was not successful, I am happy to support amendment 19 in the name of Janis Hughes, although I would rather that it was not watered down by Executive amendments. However, what is important this afternoon is that we include something in the bill that will be of benefit to carers.

I was minded to support the Executive's amendments 19A to 19G, but as Janis Hughes said, the minister's contribution was not as persuasive as it could have been and left a lot of unanswered questions. We need a number of assurances. In particular, health boards have to be monitored in their implementation of any information strategies for carers. An assurance should be given that if those strategies are not seen to deliver what is required for carers, and change does not happen, further steps will be taken to address the matter with health boards. I hope that we will be given that assurance this afternoon.

Photo of Mary Scanlon Mary Scanlon Conservative

I am grateful to the minister for apologising for the lateness of the Executive amendments. I hope that she appreciates that the seeking of clarification is based upon the lateness of the amendments.

I support the ability to give GPs more information to give to carers. I also support Janis Hughes's point about the valuable work of the Princess Royal Trust for Carers, which found 6,000 hidden carers. I do not think that that work even covered all of Scotland; it was limited to certain areas. That proves that the Parliament is right to be concerned. By finding 6,000 hidden carers, the trust has proved that there are many carers who do not know who to contact, and who are not getting the support, advice and assistance that they need.

I commend the work that the minister is doing with the Clinical Standards Board for Scotland and the Scottish Consumer Council to produce the new mark 2 patients charter. However, I seek clarification. We started this afternoon with Shona Robison's amendment 18, which sought to place a duty on the NHS to provide information to carers. Janis Hughes has asked for a strategy to identify carers in health board areas. I do not want health boards to duplicate a register that is held by local government; I can appreciate that argument.

Janis Hughes's other point concerned

"ensuring that advice and information about those rights is available free of charge to any ... carers and to carers living elsewhere ... in the Health Board's area."

I am all right with that, apart from my reservation about duplication with local government. Will the minister confirm that the Executive's proposals, as set out in amendments 19A to 19G, will apply to all carers whose cared-for person has been in recent contact with the NHS? Will the proposals apply to everyone who has passed through the doors of the NHS who does not have contact with local government? Will the minister confirm that everyone will receive that level of advice, support and information?

Amendment 19A refers to

"carers who appear to the Board to be persons who may have rights under section 12AA of the 1968 Act".

I am unfamiliar with that act. Will the minister confirm that the amendment covers everyone who passes through the NHS, or say whether it is exclusive?

Photo of Margaret Smith Margaret Smith Liberal Democrat

Janis Hughes's amendment 19 and Shona Robison's amendment 18 incorporate something of the spirit of the Health and Community Care Committee's discussions about carers and of the need for further recognition of the central role that carers play in the provision of care. Many carers have told many members that they have had a poor experience when policy has been left to guidance. It is important that the bill contains a provision on strategies.

Like many of us, many carers access services through the NHS's primary care services, rather than through social work departments. Many carers would not consider themselves carers. They see themselves as mums, dads, sons, daughters, family members or friends. They would not label themselves carers. They may prefer not to have anything to do with social work and to try to struggle on with the situation, but it is likely that they will have access to and contact with the health service, usually through their general practitioners. The health service, as well as local authorities, must enter into the duty to inform, engage with and form a meaningful partnership of care with carers.

A key point that Isobel Allan of Carers Scotland made was about the need for access to information. She said:

"carers do not get out all that much."—[Official Report, Health and Community Care Committee, 24 October 2001; c 2068.]

One consequence of not getting out much is not having access to information. One place that carers might get out to is their GP's surgery. GPs must have a duty to give access to information and to play their part in the wider strategy. Their part must involve more than handing a carer a leaflet and shooing them out of the door. I would like to hear more about how the minister expects the giving of information to be developed into a strategy and a partnership with social work departments and others.

I note that health boards will be required to consult on the strategy. That will be important in ensuring that patients, carers and partner organisations can make proposals for developing such a strategy most effectively. I do not think that any member wants duplication to occur, but having carers slipping through the net, as they do at present, is worse than duplication.

It might be worth while monitoring implementation of an information strategy as part of a health board's performance assessment. I would like to hear from the minister about that.

Amendment 19 acknowledges the work of carers in partnership. As the minister and Janis Hughes did, I acknowledge the continuing non-statutory work that is performed in the health service, the work involving the Royal College of General Practitioners, the Clinical Standards Board for Scotland and GP practices throughout Scotland and the good work that the Princess Royal Trust for Carers has done on carer identification and information.

Such work can go only so far. The bill must contain a provision on strategies, which is why I was happy to support Janis Hughes's amendment 19. If I receive answers to my questions, I believe that I will be happy to support amendment 19 as amended. It will represent a step forward. We may end up having to go further in other ways that involve the initiatives that are being developed throughout the NHS. We must do all that we can to ensure that carers do not slip through the net between social work and the health service.

Photo of John McAllion John McAllion Labour

The fact that amendments 19A to 19G were lodged at the last minute makes it difficult for any member to grasp the full significance of what the Parliament has been asked to agree to. That is a serious matter. Given that the Scottish Parliament does not have a revising chamber, there will be no opportunity after today's stage 3 debate for members to understand fully what we are being asked to voice support for. If this is a precedent, it is a bad precedent for the Executive to be setting for the Parliament.

I support fully amendment 19 in its original form. When the minister introduced her amendments to amendment 19, she said that she thought that the amendment had a number of technical and/or policy flaws. I understood the minister's objection to amendment 18, which was technical. Amendment 18 was flawed, as it would have given two different authorities the same duty to inform people.

I am not clear about the minister's objection to amendment 19. Is it the result of a similar technicality or is it about policy? As I understand it, the Executive's objection to amendment 19 is that it requires the production of a carer identification strategy. Most of the Executive's amendments to amendment 19 remove the references to a carer identification strategy and replace them with references to a carer information strategy. The difference is important. It is one thing to be required to provide information to carers that an authority knows about, but a completely different thing to be asked to produce a strategy to identify carers that an authority does not know about. Is the minister arguing that that is not the role of the NHS? Is she arguing that the NHS should not be required to identify carers whom it does not know about? Is that not appropriate for the NHS to do?

If that is the minister's argument, what is her response to the references that have been made to the on-going Princess Royal Trust for Carers focus on carers initiative? The initiative involves the trusts and GP practices in the national health service working to identify carers. If it is good for that initiative to go ahead in some areas of the NHS, why is it not good enough for it to go ahead in other NHS areas?

Debates such as this should take place at the earlier stages of a bill, rather than at stage 3 when the Parliament is asked to support something that MSPs—most of whom have not followed the progress of the bill in any detail—do not understand fully. I do not understand the minister's argument and I am a member of the Health and Community Care Committee. The minister's summing up is absolutely critical to persuading the Parliament that the Executive's amendments to amendment 19 are necessary at all.

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

I associate myself whole-heartedly with John McAllion's opening and closing remarks. The late lodging of the Executive's amendments to amendment 19 has placed every member of the Parliament in an extremely difficult position. The amendments are substantial and we are being asked to support them without adequate opportunity for scrutiny or debate. The Executive has set an extremely bad precedent; the late lodging of its amendments to amendment 19 is an example of how not to pass legislation.

I do not want to rehearse all the arguments that other members have made this afternoon. Suffice to say that I support Janis Hughes's amendment 19 on the exactly the same basis that I supported amendment 18. I am concerned that, on face value, the Executive's amendments appear to water down the impact of Janis Hughes's amendment 19.

The Executive's amendments remove the references to a carer identification strategy, but how can information be provided to people if their existence is not known about? That is a potential weakness of the amendments. The minister will have an opportunity, in summing up, to try again to reassure us that that would not be the practical effect of the Executive's amendments.

As Shona Robison said, the SNP is interested, in the spirit of compromise, in securing in the bill a provision that will offer a step forward for carers. For that reason, we are minded to support the Executive's amendments. If we did not support them, we would be putting in jeopardy the passing of amendment 19, and that would be to the detriment of carers.

The minister has a job to do to answer some of the many points that have been made and the questions of concern that have been raised throughout the chamber. We need to know that, in practice, the amendments will not constitute a watering down of the intention of Janis Hughes's amendment 19. As Shona Robison said, we need to know that efforts will be made to monitor the effectiveness of the implementation of amendment 19. That would ensure that the provisions of the amendment have the desired effect. If the minister can answer those points, the SNP will give its support to the Executive amendments to amendment 19.

The will of the Health and Community Care Committee was formed after hearing a wealth of evidence from carers organisations about the importance of having a provision such as a carer identification strategy in the bill. It is crucial that the committee's will be heard. I urge the minister to address all the points of substance that have been raised and to persuade us that supporting the Executive's amendments is the right thing to do.

Photo of Donald Gorrie Donald Gorrie Liberal Democrat 3:30 pm, 6th February 2002

I support some of the points that have been made, particularly those made by John McAllion. As I am in no way an expert on health, I want the minister to explain to me in English that I can understand why I should vote for her amendments. At the moment, I do not see why I should do so at all.

I understand that amendment 19 is about the identification of carers. I have visited one of the offices of the Princess Royal Trust for Carers—doubtless other members have done the same—and it is quite clear that one of the main problems is that many people in the community do not know that they are carers and that, as such, they can receive help.

It is important to identify carers, but the Executive is obviously against doing so and I would like it to explain why. Amendment 19F refers to a "carer information strategy" and "revised carer information". Does the carer information strategy include the identification of carers? If so, why is the Executive so concerned to remove reference to the identification of carers from the bill? If, on the other hand, the carer information strategy does not include the identification of carers, what on earth is it all about?

Photo of Dennis Canavan Dennis Canavan Independent

Not for the first time, I listened with great respect to my good friend John McAllion's comments. I sincerely hope that the Executive will listen more attentively to what he had to say than did the chief whip at Westminster, who tried to dismiss him—and indeed Malcolm Chisholm—as being simply oppositionist.

I also listened with great respect to Janis Hughes. The Parliament should listen with the same respect to what she has to say on the subject. I believe that, in a previous incarnation, she was a member of the honourable profession of nursing. That was before the electorate of Rutherglen relegated her to a less honourable profession. That said, we are grateful for her comments. The Parliament is enriched by members such as Janis Hughes, who has given years of service to the NHS and can now tell us about that experience in parliamentary debates.

Amendment 19 is worthy of support and I have no quarrel with the Executive's proposal to change carer identification to carer information in the title of the proposed new section. If a strategy is to be effective, it must not only identify carers and their needs, but ensure that carers receive information about their rights. However, I am concerned that the overall effect of the Executive amendments to amendment 19 would be tantamount almost to wrecking the amendment.

Photo of Mary Scanlon Mary Scanlon Conservative

Does the member share my concern that carers need to be identified before they can be informed? The Executive proposes a move from a carer identification strategy to a carer information strategy, but we need to know who carers are before we can give them information.

Photo of Dennis Canavan Dennis Canavan Independent

We should have both: we should have identification and then information. What is the point of identifying carers unless there is a subsequent effort to give them information about their rights, the assistance that is available to them and so on? That said, I have no serious quibble about simply changing the title from carer identification strategy to carer information strategy.

I am gravely concerned about the effect of the rest of the Executive amendments to amendment 19, which would be to blow a huge hole in amendment 19. That is especially true of amendment 19A. Amendment 19 stipulates what the contents of the strategy should be and states that any health board should submit a strategy for:

"(a) identifying carers living in the Health Board's area;

  1. informing such carers about their rights ... and
  2. ensuring that advice and information about those rights is available free of charge to any such carers and to carers living elsewhere who care for persons living in the Health Board's area."

If the Executive had its way, it would sweep all of that out of amendment 19. We would have a strategy—which would be called an information strategy rather than an identification strategy—but there would be no definition in the bill of what the strategy would contain. It is incumbent on the minister to tell us in summing up exactly what the Executive proposes should be contained in the strategy and why the Executive is so reluctant to ensure that the contents of the strategy are written into the bill. The Parliament should not leave things solely to the discretion of a health board or the Scottish Executive. If the strategy is to be meaningful and delivered effectively, its contents should be written into statute.

I ask members to support amendment 19 and to reject the Executive amendments.

Photo of Margaret Jamieson Margaret Jamieson Labour

I whole-heartedly support amendment 19. I base my support on the evidence taken by the Health and Community Care Committee. I also recognise that a lot of innovative work is going on in community care.

I must take exception to something that Dennis Canavan said with regard to nurses. Although I was not a nurse, I know that community care is not just about health care professionals. A lot of voluntary organisations work in partnership with primary care teams and GPs. I congratulate the Princess Royal Trust for Carers centre in Kilmarnock, which has been involved in significant innovative work through its focus on carers initiative for GPs. The trust and GPs have together identified 800 hidden carers in East Ayrshire, which also takes in my colleague Cathy Jamieson's constituency. In another area, the trust has worked closely with what many people think of when they talk about the health service—the hospitals. The hospital discharge pack that the Princess Royal Trust for Carers has provided has helped to identify a further 500 carers.

I understand from Malcolm Chisholm that the GP accreditation scheme will include aspects of working in partnership with other agencies as well as the way in which GPs identify and deliver information to carers, irrespective of age. The minister may want to confirm that in summing up. I know that individuals, including constituents, will have told ministers that they have come across general practitioners who are not interested in that aspect of community care. That concerns the committee.

When we took evidence, the committee decided that we should pursue the matter further. It is only right and proper that the Executive should address amendment 19. The Executive says that there is a partnership approach and that there is a duty on local authorities. I accept that, but I think that we need to tell those working in the broader health care world that they also need to play their part. If, we find that the legislation that we are passing today is not sufficient in that respect, we reserve the right to come back and make it an absolute duty.

Photo of Dorothy-Grace Elder Dorothy-Grace Elder Independent

I support everything that Janis Hughes and Margaret Jamieson, who are fellow members of the Health and Community Care Committee, have said. It is sad that amendment 18 was disagreed to, because it sought protection for carers.

Amendment 19 also seeks protection—I back that fully. I remind the minister that, of the more than 600,000 carers in Scotland, about 80,000 are well over pension age. There are also many child carers, but we do not know how many. It is therefore all the more important that we protect carers—as well as the cared for—as much as we can. That was the Health and Community Care Committee's unanimous intention. I appeal to the minister not to water down the proposals any further.

Photo of Murray Tosh Murray Tosh Conservative

I would like everybody to be clear about where we go from here. I am about to call the minister to wind up on amendment 19A, after which I will put the question on amendment 19A and the other amendments to the amendment. Following that, Janis Hughes will have the opportunity to sum up on amendment 19, whether or not it is amended. I invite Janis Hughes to respond to what has been said about amendments 19A to 19G.

Photo of Janis Hughes Janis Hughes Labour

I thank Dennis Canavan for his kind remarks, although I have not practised as a nurse for some years. I hope that he never has to avail himself of my resuscitation skills because I might be a bit rusty. [Laughter.]

On a serious note, I share the concerns of members about the manuscript amendments. It is not an appropriate way to conduct legislation. Had we had more time to discuss the issues we may have been in a different position. However, we must move forward with what we have got. I hope that the Executive will take on board my concerns for future legislation.

I hope that when the minister sums up, we will hear further comments, particularly on the points raised by Margaret Smith and others. It is important for us to recognise the work and needs of carers. In the spirit of moving forward and ensuring that something is enshrined in legislation, it is my inclination to accept the manuscript amendments. However, I should say that I am going down that road because of other things that we have heard today and that I have heard over the past couple of weeks, while I have been considering the matter.

Initiatives at the Princess Royal Trust for Carers—which was mentioned by Margaret Jamieson—and other initiatives by GPs, local health care co-operatives and health care professionals throughout the country show that there is willingness to be involved in helping to inform and identify carers. On that basis, I am prepared to accept the Executive's amendments, but I emphasise my hope that we will not be put in a similar position again.

Photo of Mary Mulligan Mary Mulligan Labour

I will try to respond to the points that I managed to note down. I start with Shona Robison's first contribution, on how we will monitor any strategy that is developed. I assure the member that there is no question of our not wishing to do that. I have tried to say to members today that we are all looking for the same outcome. If the intention is to provide support for carers, there is no way that we can sit back and allow a strategy not to deliver it.

Photo of Shona Robison Shona Robison Scottish National Party

Will the minister respond to Margaret Smith's suggestion that monitoring implementation of the information strategy should become part of the performance assessment framework for the NHS?

Photo of Mary Mulligan Mary Mulligan Labour

There will be a number of strands to the framework, but that suggestion would require a new piece of legislation.

Mary Scanlon referred to hidden carers. She will accept that that area needs to be handled sensitively. It is not necessarily the case that the NHS will do that alone—it can work in collaboration with organisations such as the Princess Royal Trust for Carers, which has the flexibility to adapt to local situations. Mary Scanlon mentioned how successful that organisation has been at adapting; we wish to build on that success in the future.

I assure members that our amendments use the definition of carers that is used in the bill, which is that carers are those who give regular and substantial caring.

Margaret Smith asked whether information will be available through GPs and how that will happen. Provision of information will be brought about as part of the strategy that the health board must produce under the bill. I expect that to happen in collaboration with other parties, including carers and carers organisations. In that way, we will be able to ensure that the information is delivered in the most appropriate way.

Photo of Mary Scanlon Mary Scanlon Conservative 3:45 pm, 6th February 2002

I support and commend the work of the Princess Royal Trust for Carers. I would like to think that everyone in Scotland has the opportunity to be registered or acknowledged as a carer. Does the minister agree that the guidance to the Carers (Recognition and Services) Act 1995 was supposed to provide NHS engagement with carers? Is she aware that research by Audit Scotland in 2001 showed that only 15 per cent of carers of older people had been asked if they needed support? Is the minister concerned that although there is a lot of good practice and guidance, it is not being adhered to or implemented?

Photo of Mary Mulligan Mary Mulligan Labour

There is good guidance and there is evidence to prove that it is beginning to be taken up in the community. There will be an increase in the number of people who are recognised as carers. The bill will support that through the duty on local authorities and the duty that we are seeking to place on the NHS.

Photo of Robert Brown Robert Brown Liberal Democrat

In the light of the proposed changes, will ministers exercise the power that the proposed new section introduces by requiring health boards to produce strategies? Will the form of the strategy include key issues related to the identification of carers? A number of members who have not been involved in the debate, including me, are not clear about the Executive's view on the matter.

Photo of Mary Mulligan Mary Mulligan Labour

As I said, I expect individual health boards to work out the strategies, so I do not want to be prescriptive. I have said on a number of occasions that our ultimate aim is to support carers. That aim will have to be built into the strategy.

John McAllion raised concerns about the removal of the term "identification". One difficulty with identification is that it has a number of legal interpretations. We do not want to leave the matter open to legal interpretation. As I said to Mary Scanlon, another point is that identification is best done outside the NHS by those who are more flexible, focused and aware of local situations. That is why we want the strategy to involve organisations such as the Princess Royal Trust for Carers in identifying carers. We do not want to put a duty on the NHS to identify carers other than the carers who are presented to the NHS under the bill. In the past, carers who were in contact with the NHS found that there was nothing to support them. Carers who are in contact with the NHS should be given the information and support that they require. That would make a huge difference to their experience of the NHS.

Photo of Mary Mulligan Mary Mulligan Labour

I must move on. I might take an intervention at the end of my speech.

That brings me back to the point that Donald Gorrie and Dennis Canavan raised about identifying carers. I stress that this is about identifying carers with whom the NHS is in contact. We are not asking NHS bodies to go out and seek carers. We are saying that when they meet carers—be it in a GPs surgery, the community or a hospital—they should offer them the support and information that they need. That will make the strategy more relevant to each carer.

Photo of Dennis Canavan Dennis Canavan Independent

Will the minister give the chamber an assurance that, under the Executive's proposals, the health board information strategy will include informing carers about their rights under section 12AA of the Social Work (Scotland) Act 1968 and section 24 of the Children (Scotland)

Act 1995 and ensuring that advice and information about those rights is available free of charge to all carers in the health board area? If the answer to that is yes, why on earth is the Executive reluctant to include its own policy in the bill?

Photo of Mary Mulligan Mary Mulligan Labour

As I have said on a number of occasions, we are asking each health board to develop its own strategy. I cannot imagine a situation in which we would not expect the strategy to include that kind of information.

Margaret Jamieson asked whether the GP accreditation scheme will include how GPs address the needs of carers. It most certainly will; that scheme is already being built up.

Photo of Nicola Sturgeon Nicola Sturgeon Scottish National Party

I feel the need to offer assistance. An argument can be made for the Executive's amendments, in order that we pass good law this afternoon, but I do not think the minister is making that argument at all well. I point out to her that the things that Dennis Canavan asked her to confirm as being included in the bill are included in amendment 19A. Why can she not give straight answers to straight questions? Perhaps that would produce more clarity.

Photo of Mary Mulligan Mary Mulligan Labour

If Nicola Sturgeon listens, she will hear that I am trying to answer the questions that have been asked.

I acknowledge members' concerns about the lateness of the amendments. I apologise for that.

Photo of Mary Mulligan Mary Mulligan Labour

No, I am finishing.

I urge the chamber to support amendments 19A to 19G. They are important to turn the good intentions that underlie amendment 19 into clear and workable law. I assure Dennis Canavan and others that there is no intention to water down amendment 19. Amendments 19A to 19G clarify the responsibility that would be placed on health boards. They establish a reasonable burden that will yield results and ensure that resources and information are targeted at those who can benefit from them—the carers.

Subject to amendments 19A to 19G being made, I am happy to support amendment 19 and ask members to join me in supporting it. However, without those amendments, amendment 19 remains well intentioned but is unclear and ineffective. If it remains unamended, I ask members to resist it.

Photo of Murray Tosh Murray Tosh Conservative

The question is, that amendment 19A be agreed to. Are we agreed?

Members:

No.

Division number 2

For: Adam, Brian, Alexander, Ms Wendy, Baillie, Jackie, Barrie, Scott, Boyack, Sarah, Brankin, Rhona, Butler, Bill, Campbell, Colin, Chisholm, Malcolm, Craigie, Cathie, Crawford, Bruce, Cunningham, Roseanna, Deacon, Susan, Elder, Dorothy-Grace, Ewing, Dr Winnie, Ewing, Fergus, Ewing, Mrs Margaret, Fabiani, Linda, Ferguson, Patricia, Finnie, Ross, Fitzpatrick, Brian, Gibson, Mr Kenneth, Gillon, Karen, Godman, Trish, Grant, Rhoda, Gray, Iain, Henry, Hugh, Home Robertson, Mr John, Hughes, Janis, Hyslop, Fiona, Ingram, Mr Adam, Jackson, Dr Sylvia, Jackson, Gordon, Jamieson, Cathy, Jamieson, Margaret, Jenkins, Ian, Kerr, Mr Andy, Lamont, Johann, Livingstone, Marilyn, Lochhead, Richard, Lyon, George, MacAskill, Mr Kenny, Macdonald, Lewis, MacDonald, Ms Margo, Macintosh, Mr Kenneth, MacKay, Angus, Maclean, Kate, Macmillan, Maureen, Martin, Paul, McAllion, Mr John, McAveety, Mr Frank, McCabe, Mr Tom, McConnell, Mr Jack, McLeish, Henry, McLeod, Fiona, McMahon, Mr Michael, McNeil, Mr Duncan, McNeill, Pauline, McNulty, Des, Morgan, Alasdair, Muldoon, Bristow, Mulligan, Mrs Mary, Munro, John Farquhar, Murray, Dr Elaine, Neil, Alex, Paterson, Mr Gil, Peacock, Peter, Peattie, Cathy, Quinan, Mr Lloyd, Radcliffe, Nora, Raffan, Mr Keith, Reid, Mr George, Robison, Shona, Robson, Euan, Rumbles, Mr Mike, Scott, Tavish, Simpson, Dr Richard, Smith, Elaine, Smith, Iain, Smith, Mrs Margaret, Stevenson, Stewart, Sturgeon, Nicola, Thomson, Elaine, Watson, Mike, Welsh, Mr Andrew, White, Ms Sandra, Whitefield, Karen, Wilson, Allan
Against: Aitken, Bill, Canavan, Dennis, Davidson, Mr David, Douglas-Hamilton, Lord James, Fergusson, Alex, Fraser, Murdo, Gallie, Phil, Goldie, Miss Annabel, Gorrie, Donald, Harding, Mr Keith, Johnstone, Alex, McGrigor, Mr Jamie, McIntosh, Mrs Lyndsay, Mundell, David, Scanlon, Mary, Scott, John, Sheridan, Tommy, Wallace, Ben, Young, John
Abstentions: Brown, Robert

Photo of Murray Tosh Murray Tosh Conservative

The result of the division is: For 88, Against 19, Abstentions 1.

Manuscript amendment 19A agreed to.

Manuscript amendments 19B, 19C, 19D, 19E, 19F and 19G moved—[Mrs Mary Mulligan]—and agreed to.

Photo of Murray Tosh Murray Tosh Conservative

I call on Janis Hughes to wind up on amendment 19 and to indicate whether she wishes to press or withdraw the amendment, as amended.

Photo of Janis Hughes Janis Hughes Labour

As I have already stated, I accept the amendments to amendment 19. I wish to press amendment 19, as amended.

Amendment 19, as amended, agreed to.