Public Health etc (Scotland) Bill: Stage 1

Part of the debate – in the Scottish Parliament at 3:20 pm on 17 April 2008.

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Photo of Shona Robison Shona Robison Scottish National Party 3:20, 17 April 2008

The Public Health etc (Scotland) Bill is a vital piece of legislation. Principally, it is about the protection of the public health from infectious diseases and contamination. Current legislation dates back to 1889 and is no longer fit for purpose if we are to ensure the best level of health protection from current public health threats for the people of Scotland.

The key proposals underpinning the bill were developed and consulted on by the previous Administration, and I acknowledge its contribution. We have added to the proposals in one important respect. Part 8 of the bill contains a power for ministers to ensure that sunbed users are given accurate information about the risks of sunbed use. We have worked closely with Kenneth Macintosh on provisions to give further protection to sunbed users that he will bring forward at stage 2. I will say a little more about the issue in my closing remarks, but I leave it to Mr Macintosh to outline the proposals during the debate.

It is important to put the bill's key provisions into context. Infections cause more than a quarter of all illnesses in the world and a fifth of all deaths. They still account for more than 10 per cent of deaths in the United Kingdom. In 2007, the World Health Organization said that new infections or diseases are emerging at an historically unprecedented rate. Old threats, such as tuberculosis, are re-emerging, and many strains are now multidrug resistant. In addition, the world faces greater than ever risks from chemical, biological or radiological contamination, whether caused by accident or by criminal action. The fairly recent incident of anthrax in the Borders is evidence of the fact that Scotland is not immune from those threats. Globalisation of travel and trade mean that, potentially, diseases that were formerly restricted to far-flung corners of the world could reach us in a matter of hours.

Legislation needs to be proportionate to the risks that are posed. In the vast majority of cases, people who are infected or contaminated take voluntary measures to reduce the risk to other individuals. However, it has long been recognised that legislation is necessary for the circumstances in which they do not do so, or those in which public authorities need to step in to apply protective measures for the community at large. The few who do not accept advice or do not take voluntary action have the potential to undermine measures to limit the spread of a serious and potentially catastrophic epidemic. Civil contingencies legislation is in place and could be used in more serious public health situations, but the emergency powers for which that legislation provides are wide ranging, powerful and designed for use only in extreme circumstances. The bill will bridge the gap between voluntary compliance with public health measures and the use of more extreme emergency legislation. We recognise that a balance needs to be struck between our duty to protect the public and the rights of the individual. We believe that that balance is achieved in the bill, which is fully compliant with the European convention on human rights.

The bill is large and complex. I will not touch on all the proposals that it contains, but I will say a little about what I consider to be its key provisions. I will address issues raised by other members in my closing remarks.

The bill clarifies the roles and responsibilities of Scottish ministers, health boards and local authorities for public health purposes. That will require a limited transfer of responsibility from local authorities to health boards in relation to action against individuals who pose a public health risk and do not accept advice or take measures voluntarily. The changes are about ensuring accountability for actions taken.

The bill will in no way reduce the good partnership working on health protection that already takes place between health boards and local authorities, which I acknowledge. In fact, that partnership working will be further enhanced by a specific duty of co-operation between health boards, local authorities and other relevant interests, as set out in part 1.

There is also a requirement for health boards and local authorities to designate "competent persons" to undertake the functions that are assigned to them under the bill. It is extremely important that we ensure that those charged with responsibilities that might entail some restriction of an individual's liberty or an action that affects a person's property have the professional expertise to do so and the full confidence of the public. We also need to ensure that we fully utilise the skills of public health professionals, whatever their background, provided that they can demonstrate that they have the necessary skills and expertise.

There has been broad support for the concept of competent persons although, naturally, there has also been a great deal of debate among health professionals on what the qualifications and skills of competent persons might be. The proposed qualifications, which have been drawn up by an expert working group, will be contained in regulations that we will issue shortly for consultation. I have informed the Health and Sport Committee of the proposed qualifications, so they are in the public domain. Before it reaches a final decision, the Government will continue to listen carefully to the views of all stakeholders on the issue.

Part 2 of the bill updates our current arrangements for the notification of diseases and health risk states by registered medical practitioners and the notification of organisms by laboratories. Those arrangements are the first line of defence in protecting public health and will enable health boards to identify the risk, assess it, and, when necessary, provide a response to potential public health incidents and outbreaks at the earliest possible opportunity. Although it is supportive of the principles of notification, the Health and Sport Committee has asked us to look again at a number of issues of detail. Those are currently under consideration and, if necessary, we will lodge amendments at stage 2.

We are mindful of the requirements of the Data Protection Act 1998 and the advice of the Scottish Information Commissioner's office on the use of personal information. We are satisfied that the requirements for notification purposes in part 2 and information sharing more generally to investigate a public health incident under the bill are in line with our statutory obligations.

Part 3 of the bill sets out the powers of those investigating public health incidents. Part 5 outlines the powers and functions of local authorities to prevent the spread of infectious disease or contamination in respect of premises. All those powers are designed to deal with gaps in current hazard or workplace-specific legislation.

The majority of public health incidents are—and will continue to be—investigated without the need for recourse to statutory powers. Individuals are usually only too willing to help find the source of infection or contamination and prevent its spread. When required, food safety or health and safety at work legislation, for example, can be used. However, such legislation is not relevant to all public health incidents. We have, therefore, listened to our public health and environmental health colleagues, who advise that the powers in the bill will provide a useful backstop to ensure the protection of public health in a number of scenarios.

The committee was concerned that there should be greater clarity in the relationship between the provisions on the appointment of public health investigators and those on the designation of health board and local authority competent persons. I will reflect further on the issue before stage 2. We also recognise the committee's concerns on the court procedures that will be used under these provisions and under other parts of the bill. We intend at stage 2 to lodge amendments—to which the Law Society of Scotland has agreed in principle—to address the committee's concerns.

Part 4 sets out the powers and functions that are available to health boards. It is fully acknowledged that these are strong powers, but they can be used only in strictly defined circumstances, when the person concerned poses a significant risk to public health.

There is concern about what constitutes

"a significant risk to public health", but it is important that we retain an element of flexibility to deal with new and emerging public health conditions. To be more prescriptive would jeopardise our ability to identify and respond to new illnesses and conditions where the causative agent is not known. For example, in the early stages of the severe acute respiratory syndrome—SARS—epidemic a few years ago, we had a totally new disease that could not be identified, but which required urgent public health action.

The World Health Organization recognises the need for action in such circumstances. New international health regulations that seek to prevent and protect against the international spread of disease have moved away from actions that are required for specific diseases to those that are concerned with disease in the more general sense, including infection and contamination. I refer to diseases that present, or could present, significant harm to humans.

It is also important to note that the majority of the powers under part 4 already exist and have not been abused. The bill updates and enhances existing powers, taking into account the establishment of the national health service and modern-day public health threats. However, I recognise the concerns of the Health and Sport Committee in a number of areas, and I will reflect on them before stage 2.

The Public Health etc (Scotland) Bill is essential to the current and future protection of the people of Scotland from infectious disease and contamination. The provisions are common in legislation throughout Europe and other countries worldwide. I am pleased that the Health and Sport Committee, after a comprehensive scrutiny of the bill's provisions, has recommended to the Parliament that the general principles of the bill be agreed to. I have also considered carefully the views of the committee on a number of issues of detail, and I will respond to them as positively as I can, consistent with the fundamental principles of the bill. On that basis, I hope that the measures that are contained in the bill can move to the next stage of consideration with broad support.

I move,

That the Parliament agrees to the general principles of the Public Health etc (Scotland) Bill.