 As the Presiding Officer said, we now move to this debate. I now call on Maureen Watt to speak to her and move the motion. Fourteen minutes please, as soon as you're ready, Ms Watt. Thank you very much, Presiding Officer, and I'm delighted to open the stage one debate on the principles of the Health, Tobacco, Nicotine and Care Scotland bill. I would like to thank the Health and Sport Committee for their consideration and stage one report. I'd also like to thank the Finance Committee and the Delegated Powers and Law Reform Committee for their consideration of the bill. I'm pleased that evidence was taken from such a wide range of organisations and individuals. I welcome the opportunity to discuss the principles of the bill and the positive contribution it will make to both public health and the delivery of health and social care services in Scotland. The Health and Sport Committee made a number of detailed recommendations in their stage one report. I responded to those yesterday, but I will address some of the more significant points here today. Our bill defines electronic cigarettes as nicotine vapour products, or NVPs. The bill builds on the requirements of the EU tobacco products directive, which must apply across the United Kingdom by 20 May 2016. The directive sets standards for the composition, labelling and marketing of devices and e-liquids. On the basis of current evidence, NVPs are generally considered to be a less harmful alternative to tobacco. However, there is also consensus that the inhalation of those products is not risk-free, particularly for young people and those with some medical conditions. Although emerging evidence suggests that NVPs could help smokers to quit tobacco, there is a lack of evidence about the short and long-term effects of vaping. In the absence of long-term evidence, the committee heard a range of concerns about whether those products might normalise smoking behaviours and act as a gateway to nicotine addiction and or smoking. Debates around those concerns will continue, but we can all agree that there are certainly no benefits to be had from children playing at smoking. The revised EU tobacco products directive will place restrictions on cross-border advertising of e-cigarettes, for example, on TV and radio advertising. Our bill builds on that by taking powers to prohibit domestic advertising such as billboards, posters and leaflets. However, I do not intend to buy certain point-of-sale advertising of NVPs in Scotland. It is important that current smokers are able to access information, ask questions and receive consultation about which products might be right for them. The committee asked the Scottish Government to consider whether the NHS should issue national guidance about the potential risks and benefits of using an NVP to quit smoking. The Scottish Government is working with NHS boards to establish a consistent approach to providing advice and support to individuals who want to stop smoking using NVPs. The bill will introduce an age verification policy for the sale of NVPs and tobacco. It will also ban unauthorised sales by a person under the age of 18. Those measures strengthen the age restrictions associated with sale of tobacco products and NVPs. Likewise, banning the sale of NVPs from vending machines reflects the fact that self-service vending machines cannot satisfactorily include a process for the vendor to verify age. Any person who intends to sell NVPs will be required to register on our retail register. This requirement has been in place for tobacco products since 2011. It has proved a useful tool for trading standards officers in supporting retailers and enforcing tobacco sales legislation. The approach taken in the bill provides consistency across tobacco and NVPs without placing undue burdens on retailers. The committee highlighted concerns that extending the tobacco register to NVPs could mislead people to think that they have the same level of harm. That is not my intention. In implementing the legislation, the Scottish Government will explore opportunities to provide a clear separation between the products on the website where the register is publicly available. The bill also proposes an offence of smoking and of knowingly permitting smoking in the perimeter around buildings on NHS hospital grounds. That is not about stigmatising smokers. Smoking ill health is a major challenge for our health services now and in the future. Tobacco remains the biggest cause of preventable disease and death in Scotland. The committee heard evidence that our NHS must show leadership in supporting and promoting healthy behaviours, particularly around tackling smoking. The bill provides an enforcement tool to support existing smoke-free hospital ground policies. As an alternative, the committee suggested that the Scottish Government considers allowing NHS boards to set different perimeters within their own grounds. However, it is important to recognise that boards have been encouraged to set their own smoke-free grounds policies since the introduction of smoke-free legislation nearly a decade ago. In developing our current tobacco control strategy, there was a clear ask of government to support a consistent approach across boards. In introducing legislation to support smoke-free policies, I believe that consistency is essential. It is important that we can communicate a simple and clear message about the requirements of the law. Setting perimeters with a different distance at each NHS hospital site could lead to confusion about what constitutes an offence. The Scottish Government will, however, consult with health boards in developing the details of the smoke-free perimeter. I wonder whether the minister could give us an indication if any patients who are smokers have signed themselves out of hospital early because they have been unable to smoke and whether that causes further problems down the line for those patients and for the NHS. I can tell the member that I am not aware of that happening if he has got evidence of that happening. I am happy to look into it. Obviously, I would have hoped that patients would discuss their smoking with their doctors and consultants perhaps even before they are due to have an operation. Obviously, help is given to patients who are coming into hospital to quit as soon as they know what the situation is within hospital grounds. I move to the duty of candour. The provision of health and social care services is closely associated with risk and unintended or unexpected events resulting in harms sometimes happen. That does not mean that we should not be honest and open when harm occurs and to seek to learn and improve from such incidents. Being candid promotes a learning culture, accountability for safer systems, better engages staff in improvement work and engenders a greater trust among patients and service users. When there has been harm, people want to be told honestly what happened, to be supported, informed of what will be done and to know what actions will be taken to stop this from happening again. That is why we have included a duty of candour provisions in part 2 of the bill. That will be a duty on organisations that provide health and social care to follow a duty of candour procedure where there has been an incident of physical or psychological harm. That will provide a further dimension to the role of organisations to support continuous improvements in the quality and safety culture across Scotland's health and social care services. That is one of a series of actions that should form part of organisational focus and commitment to learning and improvement. The duty of candour will apply to a wide range of health and care services across Scotland, because it is an organisational duty that will not apply to individuals providing services. It may be helpful if I explain the key steps of the duty. Those key steps will be set out in regulations that will be made using the powers in the bill. When an organisation becomes aware that there has been an adverse event resulting in harm, it must ensure that those affected are notified that this has happened. An account of the facts of what happened should be provided. Organisations must offer support to the person harmed and to relatives and staff who have been involved with the event. Those affected must be informed of the further steps to be taken to review the event and be given the opportunity to have their questions considered by the review process. Finally, the organisation must also provide an apology and must confirm all the actions taken in a written record. The contents of the report will inform the regular public reports of discloseable events and organisational response of those. It must make progress if you want to ask me a question in your speech. I will happily answer them in the closing. Key to this will be an organisational role to ensure that all staff who are asked to be involved with a duty of candour procedure have access to the relevant training, supervision and support before, during and after their involvement. All organisations will be required to report publicly on the number and nature of the events that have been disclosed to people and to confirm that the requirements of the organisational duty of candour have been met. It is worth remembering that legislation forms only part of the duty of candour. In addition, we will produce guidance and national training resources to assist organisations in the implementation of the duty of candour. Many organisations will already have procedures in place for handling complaints or responding to adverse or significant events. We consider that for most the additional administrative demands of the duty of candour should be minimal. Part 3 of the bill creates offences of ill treatment and willful neglect, which will apply to health and social care workers and provider organisations. The offence will cover intentional acts or omissions and are not intended to catch instances of mistake. I know that neglect and ill treatment occur very rarely in our health and social care system and those offences will allow the criminal justice system to identify and deal with those cases effectively and appropriately when they do arise. Since around 1913, there has been a criminal offence of willful neglect or ill treatment of patients in mental health care. It is right that the deliberate neglect or ill treatment of anyone who receives health or social care should be dealt with in a similar way. The offences are intended to help to secure access to justice for those who suffer neglect or ill treatment. There are two offences in the bill, one that covers health and social care workers and another that covers health and social care providers. Those offences are not about catching people who are doing the best that they can in their job. They are about dealing with those situations where someone wants to neglect or ill treat another in their care and sets out to do so. I would like to emphasise the difference between the offences in this part of the bill and the unintended or unexpected incidents covered by the duty of candour, which I referred to earlier. The ill treatment and willful neglect offences are intended to capture very deliberate acts or omissions. The duty of candour is about increasing openness and transparency where something unexpected or unintended has happened. The Scottish Government launched a consultation in September to explore the issues around extending their offences to children's health and social care services. We greatly value the input and expertise of our partners in the area of child protection. Following their input, I can confirm that I will not bring forward an amendment to extend the offence and the response to the consultation that will be published on 3 December. I look forward to the debate and ask Parliament to support this stage 1, a decision time this evening. Many thanks. I now call on Duncan McNeill to speak on behalf of the Health and Sport Committee. Ten minutes or thereby there's a little bit of time in hand, but not all that much. Thank you, Deputy Presiding Officer. From the adverts showing Ronald Reagan giving cigarettes as gifts at Christmas to Superman, jumping out of a helicopter advertising cigarettes, long gone are the days when cigarettes were so fashionable that around half all UK adults were regular smokers. Decades later, while attitudes have drastically changed, cigarette smoking is still the world's leading cause of preventable poor health and premature death. In Scotland, tobacco use is associated with over 13,000 deaths and around 56,000 hospital admissions every year. A key part of the bill aims to tackle that further by making an offence to smoke within part of a designated no smoking area around buildings and hospital grounds. Those costs smoking would be liable on somebody's conviction to a fine of up to £1,000. At present, all NHS hospital grounds are indeed no smoking. Areas and this bill would not change that. What it proposes to do is to enable no smoking areas around hospital buildings to be enforced by local authority officers. Currently, those people who refuse to comply with no smoking areas and hospital grounds can only be asked to leave those grounds or move on. We all know that that has caused a great deal of concern to our constituents by our casework, objections, complaints and, indeed, in the Greenock Telegraph's campaign about the abuse of the no smoking rule at Inverclyde Royal Hospital. Thankfully, not just locally, most witnesses agreed that smoking immediately outside hospital entrances and exits and outside windows should be an offence. However, as a committee, we had concerns about the feasibility of the Government's approach to setting the same set distance—possibly 10 or 15 metres—from every hospital building as the enforceable part of a larger no smoking area. We recommended that the Scottish Government reviews its approach and instead allow each health board area to propose its own legally enforceable perimeter. That would enable it to reflect on the different grounds and types of hospital in each board area. I note regrettably that the minister disagrees with the committee's recommendation because the Government considers that if NHS grounds each have different enforceable areas, that could lead to patients inadvertently committing an offence. However, I would seek the minister's views on whether those same issues could not arise under the Government's proposed approach. For example, if the enforceable perimeter is set at 10 or 15 metres, then for some hospital, that could extend the offence to all hospital grounds, while for others it could be a small part of the ground. Indeed, the enforceable perimeter could be less than 10 or 15 metres if an exempted site such as a hospice is co-located within the hospital. Another part of the bill introduced restrictions on the sale and advertising of nicotine and non-nicotine vaping products. None of us could have failed to have noticed the rapid increase of people using e-cigarettes, vaping pipes, hook-up ends—I have no experience of those things—or whatever else they might be called. However, we heard that there are currently 2.6 million people in the United Kingdom using NVPs. Our online survey received many comments of the benefits of using NVPs to reduce or stop cigarette smoking. However, research published today appears to suggest clearly that NVPs can help in smoking cessation and are indeed much less harmful than tobacco cigarettes. They may not completely be harmless, so we agree that more long-term research is needed. We agree with the bill and its proposers that nicotine vaping products should be treated as an age-restricted product, including restrictions on sales to over 18s. One area of debate was in relation to the powers in the bill that enable ministers to introduce additional restrictions on advertising to NVPs over and above those in place at EU and UK level. The Scottish Government has confirmed that it would intend to use those powers to restrict advertising of NVPs to the point of sale only. We supported the precautionary approach, given the long-term evidence of using NVPs, and it is still developing. I also welcome the Scottish Government's acknowledgement of our concern that a possible unintended consequence of implementing further restrictions on advertising in Scotland could be to provide a competitive advantage to those already existing NVP retailers. We welcomed the Government's intention to monitor the potential risks of NVPs, to be made more attractive to children through flavourings and the point of sale advertising. Part 2 of the bill focuses on the impact on people when mistakes arise in health and social care services. That part of the bill proposes to give health and social care and social work organisations a duty of candour. That means that when a person experiences or could have experienced an unintended or unexpected harm from their care unrelated to their illness or condition, that organisation has a duty to tell them. Whilst many witnesses supported the duty of candour in the bill, we also heard evidence that there was no need for the legislation, given that there are long-standing professional and ethical duties that require candour or disclosure of harm. Whilst we recognise that those duties currently exist, the committee supported in its inclusion in the bill because it builds on existing good practice, but more importantly because the duty will focus and apply to organisations. The duty of candour procedure will be set out in regulations that will be subject to negative procedure. Those regulations will play a significant part in ensuring that the duty of candour procedure is implemented effectively. We therefore agree that that should be changed to become an affirmative procedure in its response to the committee's report that the Government disagrees. Given that, I invite the minister to consider further how the Parliament might be given a greater opportunity to fully scrutinise the significant regulations when they are brought forward. The final part of the bill proposes to create new offences of ill treatment or willful neglect. One offence would apply to an adult health and social care workers and the other would apply to adult health and social care providers. We have heard concerns that the creation of those offences would work against the openness and honesty and candour that part 2 of the bill seeks to create. The minister clarified for us that this concern should not arise as it triggers for engaging the duty of candour that is unintended or unexpected harm, or separate and distinct from those that will trigger the offence of willful neglect or ill treatment. That is deliberate acts with a high level of intention. That said, we recognise training and education for all health and care staff will be key to the successful implementation of the procedures for the duty of candour and the new offences. This is a large, diverse bill, and I have not been able to do justice to all the committee's recommendations and the time allowed. However, I would like to place on record the committee's thanks to all those who provided written and oral evidence and gave of their time, and we look forward to scrutinising any amendments at stage 2. I begin by clarifying the question that I wish to ask the minister in her opening remarks, just so that she is very clear from the outset, as I would very much like an answer to it. In her closing remarks today, it is regarding the duty of candour that she was addressing. Minister, that touches on a situation that has been brought to my attention, especially over the last six months, about care workers being disciplined at the Scottish Social Services Council. There are several of those, and an increasing number of disciplinary hearings for care workers at the Scottish Social Services Council. As you know, more and more care workers are employed every day because we have an ageing population. Currently, those care workers who are being disciplined by the SSC are not entitled by the Scottish Government to any legal aid whatsoever and often appear at those tribunals completely unrepresented, as many of them are not members of trade unions and are not entitled to legal aid through the Government. They also have to pay their own travel expenses to disciplinary hearings. When I asked a parliamentary question on that, the Scottish Government said that it does not keep records of the numbers of disciplinary hearings. I think that there is a real overlap with the duty of candour and how it will impact on people's working rights and conditions. I wanted to ask the minister quite clearly that, when the duty of candour and willful neglect comes in, will care workers be entitled to legal aid when they are being disciplined by the Scottish Social Services Council and what is the overlap in that procedure? I just wanted to make that clear at the outset. Can I welcome the bill and its wide-ranging provisions and the steps that it will take to help improving public health across a range of areas? I will start my remarks as the minister and the committee convener have by addressing the issue of e-cigarettes in our communities. Presiding Officer, there has been an explosion of e-cigarettes and nicotine vapour use in the last couple of years and becoming a very familiar sight in everyday life. Their popularity is undeniable and it can only be a positive sign that people are looking for another way to stop harmful smoking. The sudden and huge rise in e-cigarettes demands this Parliament's attention as we ensure that there is a legal and regulatory framework for them to be sold and used and brought into line with our approach to tobacco. I think that the proposals that have been put forward in the bill by the Government are sensible and measured, and they reflect the on-going development of the evidence base on the NVPs. On that basis, we are happy to support them. I notice the broad support, as articulated by Duncan McNeill, that they have gained from respondents to the health committee. I agree with the health committee that we must continue to be alive to the opportunities that e-cigarettes present as a smoking cessation tool. I welcome the Government and NHS Health Scotland's commitment to progressing that. The minister recently told the Scottish Parliament that smoking has reduced in Scotland by 3 per cent in the last year in one of the last health debates that we had. I would be interested to know from her research and evidence what role the e-cigarettes have played in encouraging that fall. I think that it would be in Parliament's general interest to know if it has been market forces and the availability of e-cigarettes that have reduced harmful smoking or if it is indeed public health campaigns, if she does have that information. We know that there are a range of views about the safety of e-cigarettes and their effectiveness as a way to reduce harmful smoking. Ash Scotland has said that vaping is less harmful than smoking, but not harm less. Cancer Research UK confirms that, while they can help to cut down or quit smoking, the reality is that the full health effects are still unknown. I am also interested in the views of Public Health England, which cites emerging evidence that e-cigarette users have somewhat of the highest successful quit rates. That takes us to the whole debate about e-cigarettes on prescription. I certainly believe that e-cigarettes represent a real opportunity towards the smoke-free Scotland to which this Parliament aspires and which the minister very recently articulated. The 2034 target of reducing smoking to below 5 per cent of the population is very ambitious. While it is one that I share and I am sure that we all share, we will not deliver on it unless we take real action to deliver that cultural change. However, while we gauge the evidence for the effectiveness of e-cigarettes in this pursuit, I welcome the cautious steps that the Scottish Government has taken to tighten up the legislation around its sales. Perhaps with the delayed but on-going work to the Scottish Government's refreshed cancer strategy to be published next year—we do not know before the election or after the election—we will see a strong public health agenda that will reflect on how we can use e-cigarettes to reduce further harmful levels of smoking. I welcome also the move to enforce the NHS's no smoking policy outside hospital, another step, hopefully, on changing smoking culture in Scotland. On the care side of the bill, we generally support the aim of a more open and transparent system that gives greater protection to patients. There is considerable support for the Government's approach to introducing both the duty of Canada and an offence of willful neglect. I hope that that will allow healthcare workers and organisations to build on existing good practice and offer a uniform standard that gives certainty to patients and staff. There is obvious concern among the RCN and the other professional bodies that represent health workers, and we must engage with them through the progress of the bill to reflect those worries and assuage them where possible. For that reason, I am pleased that the Government has committed to involving health and social care staff in drawing up the procedures, although I am slightly nervous that all of those procedures are being left to regulation. Procedures that could have significant impact on nurses and care workers' working conditions and working rights, it is slightly concerned that they are being left completely to regulation and they are not on the face of the bill, but I think that it is the right approach to involve health and social care staff in drawing them up. It is very important that we use their expertise to shape how we improve standards. On that point, I echo the committee convener's call that regulations go through by affirmative procedure for the reasons that I have outlawed that they can affect or could affect nursing and healthcare workers' working conditions and their working rights, and they should go through this Parliament by affirmative procedure and not by negative procedure. At that point, can I highlight and put on record our thanks to healthcare workers who do some of the most difficult physical and emotionally demanding jobs in our communities and allow our elderly and vulnerable to remain in their homes or support them in a care environment? Despite the high standards of the vast majority of carers and the work they do, there will always be examples where people fall below that level as in every walk of life or profession and where care is compromised. It is right that we have a system of redress for those who suffer or are inconvenienced as a consequence, but we must also recognise that if we are to set higher standards for our care workers, we have a duty to support them properly through better pay and conditions and improved training and support. Scottish Labour has already committed to paying a living wage to Scotland's care workers, and we must also investigate how we can better train and support care workers as we have rising and rising expectations of their services and the trust that we put in them to look after our vulnerable and elderly populations. We must generally raise the esteem of the job of a carer. For too long, our social care system has been treated like a second tier of our health system. If we are to move towards a regulatory system that echoes the high standards in our NHS, we must also acknowledge the duty of care to the care workers to help them in their professional development and pay them for a fair wage for the hard job that they do. Before I call on the net mill, I just want to let open debate speakers know that, at the moment, they will probably be able to give you all up to seven minutes for open debate speeches. The Scottish Government's bill that we are discussing today proposes three very important pieces of legislation. The development of policies around tobacco, nicotine and smoking in part 1, to further the Government's anti-smoking strategy, a proposed duty of candour in part 2 and the introduction of new criminal offences of ill treatment and neglect in part 3. Concerns were expressed by witnesses about all parts of the bill, and particularly about parts 2 and 3, but by and large there was support for the policy intent of the bill and for its general principles, which should allow approval at stage 1, although I have no doubt that significant amendments will come forward at the following stages. As usual, the committee clerks have done excellent work in assimilating the evidence that we received and in drafting the stage 1 report, but this time I am particularly grateful to them as I missed some of the evidence-taking sessions because of illness. At this point, I want to put on record my increasing concerns about the pressures that are being put on Parliament and particularly on members of the health and support committee as we approach the end of this parliamentary session. The Government's response to the stage 1 report came into my inbox just before 5 p.m. yesterday, and it really is not possible with a full committee meeting, which today dealt with two other bills immediately preceding this debate, to give full and proper consideration to a late and lengthy paper. I know that with six health bills to deal with before the dissolution of Parliament, time is of the essence, but in a unicamble Parliament and with no available time for post-legislative scrutiny, we need to give full consideration to primary legislation, and some of the pressure would, I think, be avoided if the Government could give us just a little more time to consider responses to our reports. I am aware that I digress. I thank the member for giving way on that point. She will, of course, know that, in many cases, the Government's response does not come out before the stage 1 report, and this reply to the stage 1 report has, in fact, been very timely. I accept the minister's explanation, but I haven't sat all day yesterday to get the report. I think that I would have probably been better to ignore the information that came in. I am just making a general point, if I do feel quite strongly about that. Part 1 of the bill was generally accepted by witnesses as the proposed controls and restrictions on the sale of nicotine vapour products on MVPs such as e-cigarettes. More or less, mirror current statutory restrictions on tobacco products. On balance, I think that this is sensible, because, although it is accepted that MVPs do not have the same harmful effects on health as tobacco, the evidence base on long-term harm is still developing, and therefore a proportionate and balanced approach to their availability for sale seems wise, although they undoubtedly do have a place as a smoking cessation tool alongside trend support. The committee was concerned, however, that, due to the current cost and complexity of registering an MVP as a medicinal product, it is unlikely that many of them will be registered as such, putting into question, I think, their use as smoking cessation aids. I hope that the industry will pursue that matter further with the Medicines and Healthcare Products Regulatory Agency. I also think that it is prudent that retailers should have to register their intention to sell MVPs, although I think that there may be some on-going disagreement about whether there should be separate registers for the two types of product, or one that includes tobacco and MVP retailers as the bill stipulates, or indeed one that covers those who sell all age-restricted products, as is tentatively suggested by the committee. I know that the Government intends to provide a clear separation between MVPs and tobacco products on the website where the register is held, because, in current evidence, the former, as I have already said, are considerably safer than tobacco, and I think that that will be welcomed. With regard to banning smoking in hospital grounds, I think that it is right to introduce enforceable legislation, because although most, if not all, health boards already forbid smoking on their premises, and most people respect that, it is not a statutory requirement. Whether the enforceable ban on smoking should be in an area defined by regulation as the same distance from all hospital buildings for all hospital grounds as proposed by the Government, or defined by each individual health board specifying its own legally enforceable perimeter, as suggested by the committee, is, I think, likely to be further debated as the bill progresses through Parliament. There is also discussion to be had about possible exemptions, particularly for mental health patients. However, as I said at the outset, the general principles as proposed in part 1 of the bill seem to be acceptable to most people who have engaged with the committee. Parts 2 and 3 of the bill are more controversial, with the Law Society, the BMA and the RCN among those expressing reservations about them. Those opposed to the duty of candor do not think that legislation is the way to create a culture of openness within the NHS, and emphasise that there are already requirements to be honest with patients about their treatment and any failings that occur. They feel that an apology for short comings will be more meaningful if it is given spontaneously, rather than as the result of a legally enforced duty. Also, because harm in this context is not specifically defined, they feel that the duty is too broad and could encompass very minor events that it is not intended to cover. In relation to the issue of apologies, I wonder if the member would welcome, as I do, at section 232, which makes clear that the offering of an apology, a statement of sorrow or regret, does not constitute an admission of guilt. That is a key way in which we may see an increase in the spontaneous or planned offering of true comfort to those who may have suffered at the hands of a mistake. I agree with the member on that, and I would be very concerned if that was not stated in the legislation. A similar lack of definition is cited by opponents of the posed new offences of willful neglect and ill treatment, levelled at healthcare professionals and organisations. Although those terms are already established in Scottish law, I do not see that as a real problem. The Law Society of Scotland supports the policy intent of this part of the bill, but considers the offences to be unnecessary, as such actions will be covered under existing common law. It is also concerned that the introduction of the new offences made attire people from entering the social care professions, so it recommends that, if the legislation goes forward, the offences should state that there must be actual injury, either physical or psychological, as a prerequisite to any criminal action. That, as it is felt, would be a reasonable way of creating a sensible distinction between cases of poor care and criminal neglect. I expect to hear more of that from the Law Society at stage 2. I am aware that, in the time allocated to me, I have just skated over or ignored many of the important proposals in the bill, which no doubt will have more detailed scrutiny at stages 2 and 3, assuming that the general principles of the bill are accepted by Parliament at decision time this evening. We will be supporting the bill at this stage, and I look forward to further discussions with stakeholders as it proceeds through the next parts of the parliamentary process. We now move to the open debate speakers. As I said, we have a bit of time in hand. Seven minutes are there, and Stuart Maxwell will be followed by Malcolm Chisholm. Thank you very much, Presiding Officer. I am glad to be given the opportunity to speak in today's debate on the health, tobacco nicotine, etc., and Care Scotland bill. As members are aware, the bill contains four main proposals to introduce restrictions on the sale of nicotine vapour products, commonly known as e-cigarettes, to make it an offence to smoking a designated area outside NHS hospital buildings, to create a legal requirement for health and social care organisations to inform people who have been harmed by their care or treatment, and finally, of course, to establish a new criminal offence of ill treatment or willful neglect in health and social care settings. I would like, if I can, to say a few words on each of those points. I want to start by talking about e-cigarettes. E-cigarettes are a relatively new product, and their use has grown very quickly indeed. Certainly when we were doing the original smoking ban in this Parliament back in 2005, there certainly was no discussion of e-cigarettes. They were basically an unknown product. They were indeed not only introduced to the UK in 2006. In 2010, only 3 per cent of adult smokers in Scotland had used an e-cigarette, but by early 2014, that had risen to some 17 per cent. Due to the fact that they are a new product, there are no longitudinal studies to show the long-term impact of using e-cigarettes. I note that Public Health England has reviewed the available evidence and have concluded that vaping is safer than smoking and that it seems to support smoking cessation, with those who use NVPs having a higher success rate in stopping smoking than those who do not. That does not mean that vaping is safe. We must not forget that it takes a long time for the damage caused by smoking to become evident. Men indeed started smoking during World War 1, when cigarettes were handed out as rations to soldiers, and deaths caused by lung cancer did not peak in men until the 1970s. Women in general did not take up smoking until World War 2 20 years later, and deaths from lung cancer peaked and stabilised in women in the 1990s, 20 years later than men, and almost exactly the same time period had elapsed between when men started to smoke and peak male lung cancer deaths as when women started to smoke and maximum deaths from lung cancer in women in about 50 years. Given that information, I believe that the Scottish Government is wise to be cautious and to restrict and regulate the sale and marketing of e-cigarettes. I support the recommendations to make it illegal to sell nicotine vapour products to those who are under the age of 18 and to provide the power to prohibit the sale of NVPs in vending machines. I am also pleased that NVP retailers will require to be registered on the tobacco and nicotine vapour product retailer register, and that they must ask for proof of age before selling e-cigarettes to customers. It is vital, with such a new product, that we protect our children from any as yet unknown health problems that may appear over time. I do however agree with the committee that the Scottish Government should seriously consider asking the NHS to provide national guidance on the known risks and benefits of using NVPs to stop smoking. In order that people who are trying to stop smoking can make an informed choice as to which types of smoking cessation products they wish to use. I also support the Government in its proposals to grant the power to restrict advertising of NVPs to the point of sale. This is a balance that can allow smokers some information about NVPs as a safer alternative to cigarettes, but we will hopefully not attract new non-smoking customers. Paragraph 90 of the committee's report states that we support the precautionary approach adopted by the Scottish Government in relation to advertising of NVPs given the need to balance encouraging smokers to switch to NVPs as a need to smoke a sensation, while also not attracting new never-smoked NVP users. I am concerned about that, because the process towards denormalising smoking in our society runs the risk of being stopped in its tracks by e-cigarettes. There is a genuine risk that the mere activity of vaping and using e-cigarettes could be seen as a route back into smoking. I am concerned that much of the TV advertising and other advertising is in fact glamourising e-cigarettes and their use, and is an attempt to attract younger and new non-smokers to take up e-cigarettes. I will give way. Mr Maxwell has already quoted Public Health England, and in his review he said that smoking prevalence has declined in adults and young people since e-cigarettes were introduced to the market. That shows the opposite of what Mr Maxwell is trying to say about the glamourisation, because e-cigarettes since their inception has seen the reduction in smoking prevalence. I disagree with the comments of my esteemed colleague from Aberdeen. The reason I do that is because the process by which, if you look at the pattern that was adopted by tobacco companies over the years of how they tried to get new markets and how they used products and that used advertising, we are seeing exactly the same process being used today through e-cigarettes. Tobacco companies are buying up e-cigarette companies, they are producing their own e-cigarette companies and they are doing it out of the goodness of their heart to get people off tobacco. That is not the reason they are doing it. All I am saying is that I think that we should be extremely cautious about this particular new product and be careful about it seeing it as a panacea towards smoking. I do not think that tobacco companies and big tobacco companies are on our side when it comes to e-cigarettes. Although the NHS in Scotland has a smoke-free policy across all its grounds, there is no sanction that can be applied if someone refuses to comply. The bill proposes a designated no smoking area around the buildings in NHS hospital grounds with a fine, as others have said, £1,000, which can be applied to anyone who preaches that rule. That means that the areas at which people congregate to smoke, the entrances to hospitals, which, as we all know, are notoriously busy, the smokers, would become smoke-free, I certainly hope. People being admitted to hospital would not have to breathe in second-hand smoke as they were taken into hospital. It would certainly, of course, be a benefit to visitors and NHS staff as well, so I certainly support that change. I am also aware that this measure would be welcomed by the general public, as Government research commissioned in 2014 showed that 73 per cent of Scottish adults supported the proposal that smoking on hospital grounds should be stopped. I now would like to turn briefly to my attention to the other two proposals in the bill, namely to place a duty of candour on health and social care organisations and to establish a new criminal offence. As we know, the NHS in England has been hit by a number of scandals and there have been, as a consequence, a number of reviews into poor care and patient safety. Those reviews recommend that there is a need for honesty and candour with patients when things go wrong. The Scottish Government has therefore decided to give a duty of care candour to responsible persons. Presiding Officer, without revealing personal details of my own background, I have experience of a mistake that was caused by NHS staff and my family. All we sought was an apology and an explanation of honesty. At the time, all they were concerned about was whether or not we were going to sue them. That is why it is important that we get candour into the whole structure. Finally, I would like to mention the last proposal to create a new offence of ill treatment of welfare neglect. I very much welcome this proposal as it provides protection for some of the most vulnerable people in our society. In light of the fact that we have an ageing population, more of us are going to use care services. That is a measure that will ultimately benefit all of us. I am delighted to be supporting this bill at decision time. We all support the ambitious target of the Scottish Government to reduce smoking in Scotland to 5 per cent by 2034. However, the simple fact of the matter is that we are not making nearly fast enough progress. I believe that starting with the first part of the bill, the e-cigarettes, has an important role to play in hastening that progress. The simple fact of the matter is that nicotine replacement therapy has never been popular. The evidence from Professor Linda Bald, who has been researching tobacco control for nearly 20 years and from public health England, is that e-cigarettes are far more effective in getting people off traditional cigarettes than other forms such as nicotine replacement therapy. We need to look at the evidence on that. It seems to me that Stuart Maxwell has not looked at the evidence from public health England or Linda Bald. I recommend that he starts by looking at a five-minute video from Linda Bald, which I put on my Twitter page today. I think that we need to look at the evidence on that and not foster scaremongering and myths. I support the proposals in the bill on age restrictions and on vending machines that are related to that. However, as public health England makes clear, there is absolutely no evidence that young people are becoming regular users of e-health. There is absolutely no evidence that they are a gateway to smoking, and there is absolutely no evidence that they are starting to renormalise smoking. I really think that we have to challenge those all-too-common myths in the population, because it is a danger to people's health. Why do organisations such as Cancer Research UK support e-cigarettes because they know that they can save lives? I certainly believe also that I am supporting what the provisions are in the bill, because we do not want to glamourise the advertising of e-cigarettes, but we want to have some advertising of them. I certainly support the point of sale advertising. I think that we can have a debate at stage two about whether we possibly—it is not actually stage two because it is going to be in regulations—we need to go a bit further than that, because the health committee also says that we want to, I quote, work with the advertising standards authority to ensure harmonisation. Clearly, they are going beyond the point of sale advertising. I give way to the register. Thank you for giving way. Mr Chisholm will know that, in order for the NHS to recommend NVPs as a smoking cessation product, they would have to be licensed, and e-cigarette companies have not asked for a licence. Why does he think that that is? I mean, the committee also dealt with that issue in terms of the complexities of that process, so that is certainly something that needs to be looked at. I was beginning to talk about the register, which is also widely accepted, but the health committee itself said that there should be a register for all age-restricted products. Linda Bald sought that there should be separate registers. It is an interesting thing. Once again, Cancer Research UK do not want them on the register at all because they are so concerned to separate cigarettes from e-cigarettes. The fundamental fact here is that it is coming from the independent scientific committee on drugs, drawing on experts from several different countries. I have come to the conclusion that e-cigarettes are 95 per cent less harmful than normal cigarettes, so let's look at what the experts are saying on this matter. Can I make one final point on that? I think that also being particularly interested in health inequalities, they have an important role in reducing health inequalities. In terms of the people who are smoking in society, that is disproportionately in many cases those from more disadvantaged backgrounds, so I think that they can also help in that regard. I am moving on to smoking in hospital grounds. Obviously, I do not support the banning of e-cigarettes in hospital grounds, but I do believe that normal cigarettes should be banned and I support the recommendations in the bill. However, it is interesting that ASH actually supports the recommendation of the health committee that individual health boards should propose the legally enforceable perimeter, so I am sure that there will be more discussion about that at stage 2. I am moving on to the duty of candor, which, as we have already heard, is in the event of a person experiencing an unintended harm. The organisation has a duty to tell, support and review and apologise. It was interesting at committee those who supported it. We have heard about those who did not support it or questioned it, but Unison, for example, supported it because they said that it would drive culture change and support a culture of learning and improvement. I think that, in principle, and certainly the committee in principle supported that, when we visited some of us from the committee, Ardgaun Hospice in Greenock, they made an interesting point that some people might not want to know. That is why I think that we should have an amendment that introduces the English arrangement whereby you tell somebody that you have something to report, but you give them the right to say, I do not want to know. I think that that is the way to do it. It must not be done in a paternalistic way. You must say to people that you have something to report, but they also must have the right to say, I do not want to know. We should have an amendment to that effect at stage 2. We also need clear guidance on the triggers for the duty of candor and a programme of awareness-raising training and support. Finally, of course, is the offence of ill treatment and willful neglect, interestingly, in mental health legislation since 1913, but arising more recently because of the mid-staff's inquiry and the Francis report, and of course we are now putting into law something that is already in law in English health legislation. Clearly, the difference here, if we are comparing it with the duty of candor, is something that is very deliberate. Duty of candor was to do with unintended harm. That is a completely different category. Although some people worry about the interaction of the new criminal offence with the duty of candor, the reality is that there should be no interaction because they are dealing with quite different categories. As with the duty of candor, it is very important that we have guidance on how the new offence will sit alongside existing processes and procedures, because some people have made the point that there already are some processes and procedures to prevent this happening. We also, on the health committee, ask for further information on training, support and education. Basically, the health committee is saying that we support the bill. I certainly support the bill, and the interesting thing is going back to where I started on e-cigarettes. Although there is quite a big difference between those who are more positive about e-cigarettes and those who are more cautious, most people are still supporting the provision in the bill, although there might be some argument about the details. In general terms, the bill, including the provision on e-cigarettes, is something that I would support, but I think that we need to put out a clear message about the evidence on e-cigarettes and the potential to stop people smoking and reduce health inequalities. I thank you, Presiding Officer. Since becoming an MSP, I have taken a very keen interest in reducing harm caused by smoking. Indeed, in July 2001, I put forward the regulation of smoking well with the strong support of Dr Richard Simpson, Bill Aitken and Robert Brown. That was taken forward subsequently after 2003 by Stuart Maxwell. Eventually, the Scottish Executive and ultimately led to the smoking ban being implemented in 2006. For many years now, I have also been deputy convener of the cross-party group on tobacco and health, which has led energetically and enthusiastically by Willie Rennie. That is a cross-party group that aims to tackle the harm caused by tobacco use in Scotland, because it is an issue that has not gone away. We heard from the convener of the health and sport committee just how many people still die and become ill through tobacco use. Of course, behaviours and attitudes towards tobacco and smoking have varied wildly over the years. Earlier today, I watched a programme on BBC iPlayer entitled Time Shift, The Smoking Years, which charts a history of tobacco use in the UK, explaining the initial hostility tobacco through to widespread use, mass consumerism, class status, addiction, medical concerns and modern public smoking bans. It is clear that, despite the long history and familiarity with the smoker, our attitudes towards tobacco and smoking continue to evolve, along with understanding of that particular drug, how it is marketed and its health and economic effects. Despite overwhelming evidence that smoking directly causes heart disease, cancers and a host of other life-threatening illnesses, smoking remains the biggest cause of preventable death in Scotland. Of course, we know that, for the tobacco companies, only young people taking up smoking allow them to continue to be able to market as other older users either pass away or give up the habit. Along with the smoking ban and other measures, the number of adults who identify smokers I am pleased to say continues to fall in Scotland and has dropped to 28 per cent of the population a decade ago to 22 per cent last year. That is happening, and my understanding is that many smokers actually smoke less than they did before, due to more restrictions on the places where they can. That clearly represents solid progress towards the Scottish Government. Indeed, everyone in the chamber's ambition of establishing Scotland is a smoke-free nation by 2034, and, as Jenny Marra pointed out, it has an ambitious target, such that only 5 per cent of the population will smoke or indeed less. As we are aware, when government intervention closes down certain avenues or restricts how tobacco products are sold and marketed, the ever-innovative tobacco industry reacts in very creative ways to ensure that they protect their margins. We have seen, for example, wholesale and unadulterated marketing to developing countries still being pushed by tobacco companies who claim that they are only interested in switching brand, not in encouraging younger people to smoke. Anyone who looks at what is happening overseas can see it as fundamentally dishonest. When advertising displays were banned, companies massively increased the variety of cigarettes that they sold in order that their brands would take up entire shelves behind kiosks. When smoking and public was banned, some companies even tried to relaunch snuff somewhat unsuccessful, although my wife and MP tells me that it is still free to members of the House of Commons as a product to be enjoyed socially. In recent years, we have witnessed an increase in nicotine vapour products, as many smokers wish to switch understandably to a potentialised harmful method of receiving nicotine, the crave. Although I personally consider that NVPs cannot be worse than a cigarette pack with thousands of harmful chemicals, the science to ascertain how safe they are remains sketchy and incomplete. For that reason, it is incredibly important that we proceed cautiously to ensure that a new generation of smokers is not created, assuming that the new pursuit is completely benign. In that regard, I agree entirely with the contribution of my colleague Stuart Maxwell. Considering that a majority of high school children have been exposed to NVP marketing, it is clear that we must ensure that they are protected. For that reason, I am pleased that, following a public consultation, the Scottish Government has taken action to restrict the sale and advertising of such products. By bringing the sale of NVPs to anyone under 18, as well as making it an offence, to purchase NVPs on behalf of someone under 18 will help to limit the supply of such products to young children and lays down an important marker showing that these products may not be safe and for the time being must be considered along with the sale of alcohol and tobacco. Other cigarettes, I am glad that this Government has included measures to prevent the sale of NVPs from vending machines and reducing another hurdle to people who seek to purchase them under the legal age. Further to this, those who wish to sell NVPs must register on a tobacco retail register as they would to sell cigarettes. That will introduce accountability for shopkeepers and help to weed out the less scrupulous who would happily sell to people under age. As I mentioned, it may be that NVPs are relatively safe and could prove to be useful tools to help people to stop smoking completely, and I am sure that colleagues in the chamber would agree with that. However, until that can be proven conclusively, I believe that the Scottish Government is right to take an evidence-paced and precautionary approach to the marketing of such products, which can ultimately lead to addiction. Regarding the duty of candor, as we have just heard from Malcolm Chisholm, Mary Curie Unison, and others such as Action Against Medical Accents in the Vice Scotland, another support legislation to drive culture change and help to ensure that organisations do shift towards learning improvement and disclosure of harm. Again, I echo Stuart Maxwell. I also had experience of this. My son died as a director as a result of medical neglect, and when one pursued an apology and measures to ensure that this did not happen to anyone else, I am afraid that that was not forthcoming. I think that that is quite appallingly an actual fact, and I would hope that such a duty would change the way health boards and others deal with such matters. Along with measures outlined in the tobacco control strategy, I believe that the bill being debated today will help to further reduce the number of smokers in Scotland, protecting the health of our citizens and ultimately leading Scotland towards smoke-free status in the years ahead. Finally, I would like to say that I very much look forward to Jackson Carlaw's closing speech for the Conservatives. I received the ballot paper for the west of Scotland regional list just a few short days ago for the Conservative ranking, and a very good speech from him could possibly influence my vote. I am at loss words. I now call on Hanzala Mallat to be followed by Kevin Stewart. Thank you very much, Presiding Officer, and good afternoon to you. When speaking in today's debate on stage one of the tobacco nicotine and the care bill, which is an extensive bill covering many different aspects of health and care, I am mainly going to focus on the tobacco and nicotine sections of the bill and the nicotine viper products, also known as NVPs in particular. As NVPs are a relative new product that appears to be a general consensus on two points. One, that the evidence-based relating to long-term harm of using NVPs is in its early stages, and two, that they do not have a role to play in helping people stopping smoking. Therefore, more evidence on the product harm from NVPs is needed. I strongly support the call by the Health and Sports Committee for more information from the Scottish Government on how to support research in this area. I also agree with the committee's recommendation that the Scottish Government to consider that the national health service should provide a national guidance on risk and benefits of using NVPs to stop smoking. We need to learn from our mistakes that society made with cigarettes. Regarding NVPs, they should not be treated as the same as tobacco, as they are not, as harmful, but we need to ensure that not as harmful message is not confused with people thinking that they are safe. I believe that there is a need for careful, we need to be careful with allowing advertising of NVPs. To confuse people, NVP advertisement should target existing smokers and not try to increase those using such products. In the early days of cigarettes, you could find advertisements stating that they can be used as slimming aids. So instead of eating between meals, you should have a cigarette in order to stay fit and not fat. Now, cigarettes can suppress your appetite, so the advertisement was not totally lying, but it was confused with the use of used images to make smoking look glamorous. Members of my own family have had serious illnesses problems as a result of smoking. But at the time they began to smoke, we did not know the risks to our health. As time went on, the evidence about the risks of tobacco grew, but by that time it was hard for them to give up smoking. As I said before, we should not repeat the mistakes of our past and we need to take cautious approach to these products, still considering submitting to whether they are in fact harmful or not. There needs to be monitoring of the risks of making sales of NVPs as an alternative and to ensure that people's safety is not protected. The Scottish Government needs to ensure that people have the fullest and clear information presented to them so that they can make that choice and I hope that the belief that this bill goes some way in ensuring that that is the case. Presiding Officer, I have had constituents write to me about the high rates of smoking amongst people with mental health problems. I understand that smoking is also falling at a slower rate amongst these people. We can see people moving from smoking to long-term use of NEPs as an alternative. I personally know of one person who has been vipering for a number of years and at times of stress he has had two or even three vip sticking out of his mouth. Of course, it is that person's choice to do such a thing but it demonstrates issues we have not tested. Hence, I wish the committee's speed in researching these issues in a bid to protect our citizens. Presiding Officer, the other thing I wish to say is that we know for a fact that smoking affects our health detrimentally. Many of our citizens face very serious health problems as a result of taking cigarettes. Unfortunately, many of them smoked when we didn't have the research available to us. However, now we see a new trend in our communities where NPPs are being introduced, particularly to our young, which is very disturbing. I think it's absolutely crucial that we have legislation in place that protects our young. I think it's also absolutely essential that people, regardless of age, actually know the facts of taking NPPs and the dangers that they may cause to themselves in the short term and possibly in the long term. Presiding Officer, once again, I wish the committee every success in its deliberations and I wish that the minister will also indicate what support she can lend the national health service in trying to find some resources for additional research. Thank you very much. Many thanks. I now call on Kevin Stewart to be followed by Jim Hume. Presiding Officer, first of all, the confession. I was a smoker. I started smoking at age 14. It was not because of any advertising. It was not because of parental influence, because they did not smoke. It could be a bit of peer pressure, but I was never given to that either, but I did start smoking at the age of 14. I have given up many times over the years, sometimes for long periods of time. On Christmas Eve last year, I bit the bullet and decided to quit the fags again. I decided to give up cigarettes because I began to cough in the mornings and felt that smoking was being rather detrimental to my health. At that point, Presiding Officer, I switched to electronic cigarettes. In my opinion, the nicotine vapour products, as they are described as in the bill, have in the main kept me in the straight and narrow and away from cigarettes since Christmas Eve last year. I have to admit that I still have cravings for cigarettes on almost a day and daily basis. Today is not being particularly helpful in that regard, but while I managed to quit previously by going cold turkey, I always ended up returning to cigarettes. There is little doubt in my mind, Presiding Officer, that electronic cigarettes have helped me to quit my 20 plus a day cigarette habit, have allowed me to cut down on my nicotine intake and I have to say that I feel much healthier than I did prior to the 24th of December last year. I am not alone in that regard. In its systematic review of e-cigarettes, the Cochran library found that almost one in ten smokers using e-cigarettes had been able to quit smoking up to one year later and that around one third had cut down smoking. The trial data showed no adverse effects from short to medium-term use of e-cigarettes. I firmly believe that, although young people should be discouraged from smoking and vaping, adult vapers who are using e-cigarettes to quit or cut down their smoking should not be demonised for their efforts. One of my constituents wrote to me recently because he was scared of a possible vaping ban and he said, I used to smoke but I haven't had a cigarette since the first of October 2014. Notice how we all remember the dates here when we quit. I started with the white e-cigs and now I'm on to more complicated mods and tanks. I stopped smoking because I have angina and vaping seems to be okay in the terms that I can breathe easier. The provisions contained in this bill to introduce a minimum purchase age of 18 for MVPs to prohibit sales from vending machines for dealer registration and for advertising restrictions do not bother me one iota. However, we have already seen attempts in this Parliament to demonise those who are using e-cigarettes with some suggesting that those devices are the alco-pops of the nicotine world. Based on scant evidence and of course this Parliament banned the use of e-cigarettes on the campus on the basis that they were following the precautionary principle. Could this be construed as demonising people for their efforts to try and quit smoking? I hope not. I intend to support the bill at stage 1, but I would have grave concerns if any attempts were made to restrict vaping at stage 2. I hope that colleagues will not try to use the bill to try and achieve other ends. In relation to the folk who have suggested that e-cigarettes are the alco-pops of the nicotine world, it runs counter to the review that I mentioned earlier in response to Mr Maxwell, which was carried out by Public Health England, which stated that smoking prevalence has declined in adults and young people since e-cigarettes were introduced to the market. Like everyone else in the chamber today, I want to see smoking prevalence continue to decline, but I have a fear that if the next target is vapours, then that decline will not be as rapid as we would wish. You may well see some people moving back on to cigarettes if they have to do the things that smokers currently have to do. There have been some things that I would like to pick up on from today's debate from my personal experience. Although some folk have indicated that they feel that the smoking ban has led to people cutting down on their smoking, I have to say that my own experience is somewhat different. When I was a smoker, I had no problem about going outside or doing all the rest of the things that we have become quite used to. However, one of the things that happened at that point was that when you were going outside, you did not go outside just for one, you would end up having two cigarettes in a row, which increased the intake of nicotine that I was getting at that particular point in time and certainly added to the bill for cigarettes. Finally, in terms of the ban and hospital grounds, I have absolutely no problem with that happening. However, I think that there is a need somewhere on those grounds, well away from entrances and other people, for some patients to be able to go and smoke rather than to see them signing themselves out of hospital at a time when they require treatment. Or, of course, the other alternative, Presiding Officer, is to allow them to vape. Thank you, Deputy Presiding Officer. I think that we should congratulate all the members of the committee for their hard work and, of course, the clerks on this report. We are again looking at the bill. It has the potential to help a lot of people who live healthier lives with better guidance and, I think, better support. It has three main provisions on MVPs vaping, duty of candor and ill treatment and neglect, which could be beneficial, of course, in principle. However, we need to look at each one in depth and distinguish what is beneficial and what could end up being undesirable and perhaps impractical. I would like to point out a few of the issues that I believe require some more evidence, as well as a better understanding of what the assumed policies aim to do. Some members have already pointed out that the move towards limiting the sale and advertising of nicotine vapour products, while the move towards restricting products that are harmful is welcome. There is a large number of evidence, and we have just heard some from Kevin Stewart, stating the fact that they are less harmful than cigarettes. Of course, we know that they are a good way of winning people off smoking tobacco, and there is little doubt that smoking tobacco is worse for you than vaping cigarettes. However, there is concerns. Of course, nicotine is a poison. It used to be used as an insecticide. It is an addictive chemical. It affects your cardiovascular system, and it can even lead to burst effects. That is all well documented by itself. There is concern that there is some targeting of non-smokers, and under 18-year-olds, you would hope, would be non-smokers, so supportive of the Government's proposals. We also know that there has been targeting, even at football matches, for those who have been giving e-cigarettes away. There are concerns, and I fully appreciate Kevin Stewart and others' views and support them. We need vaping to help people to win off the more harmful smoking of tobacco, but they are probably not harmless. I am afraid that we do not have enough evidence. There is a very fine line between what the bill seeks to promote as a better alternative to smoking for those who already smoke, and what unintentional consequences it could potentially have in promoting NPVs as something attractive to those who do not smoke, or, as some witnesses put it, glamourised products, particularly to those under 18. Members will be aware of my bill going through Parliament at the moment. It aims to raise the awareness of damage caused by the respiratory system of children because of second-hand tobacco smoke. Similarly, as we are not yet aware of the long-term impact on lungs from inhaling vapes, preventing a larger-scale problem from occurring, what a wise health policy should look like, so I am supportive. I do believe that the measure to prohibit sales of NVPs to under-18s is just a reasonable step. We know that there is a lack of robust research and evidence in this area, so it is better to err on the side of safety in protecting young people. Stuart Maxwell's evidence on that in the length of time it takes for cancers to appear from smoking cigarettes to the first time that people start was good evidence enough. We also have to consider the growing vaping market, and the word-of-mouth reputation that those products obtain among under-18s. It is a sensible measure, therefore, and one supported by numerous organisations, including Cancer Research UK. I am also supportive of the provisions that build on the Lib Dem Labour coalition legislation with regard to smoking bans, which Stuart Maxwell was very much involved in at the beginning. At that time, the chairman said that the day would be remembered as the time that Scotland took a bold and politically courageous step. The measure takes this step further to protect the hospital areas of course, health centres, GP practice grounds and other areas where health is promoted and puts Scotland closer to the tobacco-free generation by 2034 that Malcolm Chisholn mentioned. I want to move on to another element of the bill, that of the duty of candor, which, although I believe that we will provide better emotional support to patients, I think that we must ensure that its use is balanced against its necessity. Looking to the professional opinion of the BMA, I was informed that this measure could have the potential to add administrative burdens, costs and responsibilities to health boards and GP practices. Rather than what the BMA is pointing out in the procedure, is that any incident that occurs should be seen as an opportunity for improvement and learning. We know that doctors, nurses, consultants and every single medical and clinical member of staff want to help their patients and is looking out to provide the best care to them. It is, after all, a basic element of the Hippocratic Oath for new doctors, as well as an element of the general medical council's standards and ethics guidance. While I welcome the awareness that the bill raises for the duty of candor, I think that we must look to further information on how it might affect the relationship between practitioners and patients. Likewise, Deputy Presiding Officer, part 3 of the bill makes provisions for introducing offences of willful neglect and ill treatment for healthcare professionals and organisations. I will reiterate the previous point that I made that the medical personnel do not seek to harm the patients. I would try very carefully on that point as it moves forward the various stages of the bill. I would like to ask the minister for a number of specifications in the matter, given the current context that practitioners work in. We know that health boards and subsequently doctors, nurses and A&E departments are squeezed very tight financially. We just recently saw health boards boring from the Scottish Government to break even, so departments are under staff. Staff will overwork and targets are pressing, so I would be grateful in summing up if the minister could address concerns that health professionals and care workers would not be unduly criminalised for any failings. Concerns are also echoed by the British Medical Association. Its concerns also focus around the issues that, by imposing those types of sanctions, we must still not be solving the serious failings in healthcare delivery in Scotland, as they say, and adding a criminal offence would not provide any additional protection for patients. I am pleased to see that we are advancing in promoting patient care and health even further and to further make the bill reach a more optimal result. We need to look at its provisions a little more closely and to build on it more constructively to the future. Many thanks. I now call John Mason to be followed by Dennis Robertson. First, I would like to welcome the progress that has been made in smoking by the Scottish Parliament, including members who are present here. When it comes to smoking, I think that we want to get a balance between the health benefits for the public as a whole, and that includes the smokers themselves, but also allowing people the freedom to do themselves a bit of harm if they are determined to do so. Given that we have had some personal stories here this afternoon, I will just mention the fact that my own grandfather started smoking in the First World War and lived till he was 86, which encouraged my father to also smoke heavily, which he did to the tune of 40 a day, but unfortunately it did have a negative impact on his health and life. I am slightly more relaxed about smoking. I allow people to smoke in my car if they want. I was brought up with smoking in the house, smoking in the car, smoking everywhere, and so I am reasonably relaxed about it. I did try it myself briefly in my teens and did get the nickname at one stage of smokes at school. However, I think that was a little unfair because I really had only tried one or two. I do accept that it is not always an easy balance to strike. On the one hand, we can be accused of being a nanny state and interfering too much in people's lives, but on the other hand, we can be accused of standing in the sidelines while people destroy the lives of themselves and their children. I would like to concentrate on part 1 of the bill, especially on tobacco and e-cigarettes. Like other members, I have received a fair amount of material from businesses telling me what a good thing e-cigarettes are. I would have to say that I have a number of friends and colleagues who take that view as well. I am happy to accept that, for some people who are trying to give up traditional cigarettes, e-cigarettes can be a helpful way of doing that. My main concern is at the other end of the spectrum, where e-cigarettes are clearly being used by unscrupulous companies as a way to entice people to start smoking with the hope that they will become hooked and move on to tobacco products. Members may know the Ford Shopping Centre at Parkhead, which is right beside my constituency office, and often I go in there on my way to get lunch at a well-known sandwich shop. On the way, I pass various shops and stalls, and one in particular struck me when it was set up. This is a stall right in the middle of the third affair where the shoppers have to cram to get passed. It is a larger-than-life 3D model of a cigarette, and I guess that it is 20 times the size of a normal cigarette. If you look at it, it looks exactly like a normal cigarette, but that stall is advertising e-cigarettes. Clearly, to me, that huge model of the cigarette is there to glamourise and encourage smoking. It may not technically be advertising tobacco products, but in practice that is exactly what they are doing. As I said, I am not arguing that e-cigarettes have no benefits, but I would argue that they are also being used as a thin veneer for advertising tobacco and traditional cigarettes. Especially that this is a concern as children are being targeted in this way. The BMA also highlighted that in its submission for today's debate, and I can just quote a little bit out of its submission. Concerns have been expressed by BMA members over the use of marketing methods to promote e-cigarettes that are likely to appeal to children, young people and non-smokers. The BMA is also concerned that e-cigarette marketing may have an adverse impact reinforcing conventional cigarette smoking habits, as well as indirectly promoting smoking and increasing the likelihood of young people starting to smoke. Overall, I find myself very much in agreement with the committee's recommendations, particularly with paragraph 90, which has already been quoted by Stuart Maxwell. On the question of smoking in hospital grounds, we spent a fair bit of time on this at the finance committee looking at the potential costs in the financial memorandum. On the overall principle, I very much agree with the proposal that if we want to continue to change the culture in smoking, then where else would be a higher priority than on the grounds of the national health service? I take the point in the report of paragraph 117 that, by having a two-tier system, there may be less adherence in the grounds beyond the legally enforceable limits and there may also be confusion as to what is and where it is allowed and not allowed. The FM provides for signage costs at all hospitals and time will tell whether that is sufficient. On the question of enforcement, when the ban on smoking in public places was introduced, I myself was a councillor at that time in Glasgow City Chambers and was concerned that a lot of enforcement activity would be required to stop smoking in pubs, restaurants and similar places. I have to say that I am delighted that I was proved wrong and that that legislation came into effect so smoothly. I note in paragraph 124 of the committee report that the Scottish Government confirmed that it expected compliance by the public patients and staff with the enforceable no smoking areas to be as high as with previous smoke-free legislation. I have to say that I find that a little bit optimistic. I think that there is a bit of a difference between being inside a restaurant or a pub where there is a lot of public opinion right on top of you and standing outside perhaps on your own in the grounds of a hospital. On the finance committee, we received submissions from local authorities in COSLA worried about the potential costs of the new legislation and whether the financial memorandum adequately provides for those. Therefore, in our report on the FFM, the lead committee may wish to seek further clarification of whether additional funding would be made available in the event that evidence indicates an increase in the cost of enforcement, either in respect of the sale of MVPs or of smoking in hospitals. I am glad to see in paragraph 131 in the main report that the committee takes that up and says that we welcome the Government's commitment to consider any breakdown of costs provided by COSLA should there be a short-term increase in enforcement costs. Overall, this country has clearly made progress on the subject of smoking, but we want to continue to make that progress. We also need to protect the ground 1 against attempts to undermine it by the tobacco industry. Therefore, I very much welcome this bill, and I suspect that it will not be the last on this topic. Many thanks. I now call Dennis Robertson to be followed by James Kelly. I think that it is interesting that a lot of focus has been taken on part 1 of this bill. I make no apology for perhaps putting a lot of my attention to part 1 of the bill this afternoon. I think that it is also interesting that we are hearing confessions from colleagues, but it puts things into context for me. If we are making attempts to try and have a healthier Scotland, which we are, smoking in itself—I take on the board that John Mason has said that it is about choice and balance—if we have to achieve our objectives of 2034, 5 per cent, we have a long way to go, so we need to take some measures. I wonder whether we are correct to use the word choice. Where addictions are concerned, it is precisely that you are absent from choice, because that health issue denies you the choice to deprive yourself of the material that you are addicted to, in this case, nicotine. That is a very interesting approach from the member. I still believe, to some extent, although when it becomes habitual, that element of choice that can, to some extent, with the appropriate treatments, enable the person to move from the addiction. I am not quite sure that a choice is still not available to a person. In terms of the evidence that we have, Malcolm Chisholm mentioned a Professor Ball from Stirling University. Professor Ball has stated with the evidence that those who are using nicotine vapour products are 60 per cent more likely to quit smoking. 60 per cent, Presiding Officer. For me, that is a substantial number. If the e-cigarettes themselves can aid a person to stop smoking, and someone who is addicted from age 14 to last Christmas eve, I think that there is some evidence to suggest that it is perhaps a method that, even things such as people using other nicotine products, such as panzexetra and chewing gums, if the e-cigarette itself is enabling such a high percentage of people to remain off cigarettes, then I think that there is something very positive from those products. However, we still do not know, because they are so new to us, that if they have a long-term effect. That is something that I think that we need to keep in mind and obviously monitor for the future. I sincerely hope that, because I think that Stuart Maxwell made a very important point, that a lot of these e-cigarettes are now being produced by tobacco companies. It may just be that they are switching from the tobacco to the nicotine vapour products for profit, but, as he suggested, there may be some alternative side effect to this as well. With regard to the exposure, we do know that e-cigarettes have been, in relation to children, the advertising and there has been a great deal of exposure to the e-cigarettes and there has been an uptake. That is something that we need to be very guarded about. I certainly welcome the fact that we are going to be legislating against advertising just to the point of sale, which I think is incredibly important. Certainly, when we are taking evidence at committee, there was a lot of discussion around that. One of the areas in terms of the point of sale that I support is that, within the community pharmacy, where, again, I think that people can maybe take advice with regard to the product. The minister has suggested earlier that a medicine is such, because it is non-licened, and that is certainly correct. However, I sincerely hope that community pharmacy, at the point of sale, with the Nicolai Baker profits, will be able to give appropriate advice on their use as a product with regard to stopping smoking. We have taken certain other measures, which are not in the bill itself, but the Government has continued to take measures to encourage people to stop smoking. It has certainly supported when the minister launched a ticket right outside in October of this year. Again, that was supported by the British Heart Foundation, and James Cant, who is the director of BHF, has said at that point in time that, just opening a window does not protect your children from secondhand smoke, you have to take it right outside. Of course, I am sure that James Cant and many of us who are non-smokers would prefer if people stopped smoking entirely, but if those who are smoking can take it right outside much the better. That brings me on to the hospital and the hospital areas. A lot of discussion was in committee about the different hospital campus areas. Obviously, having a smoke-free area of 10 or 15 metres, it might not be able to be applied throughout the different campus because of the structural aspect of some of the hospitals. We are a bit concerned of putting down the parameter. Although the hospitals at the moment—and quite rightly so, I believe—have a policy of non-smoking within their hospital grounds, including medical centres, I believe that that is the best way to go with the possible exemptions where there are situations in which hospice or certain areas of proven mental health benefits for someone in a particular area. We also have to look at points 2 and 3 of the bill. The duty of candor for me is about openness and transparency. It is about putting your hand up. It is about saying, I made a mistake. That is okay. I think that people recognise that if something has happened at an error, we are okay about that. It is when something is actually covered up, when we try to cover up these mistakes, that is when the problem occurs. This duty of candor for me is appropriate and proportionate within the bill. The willful neglect area on part 3, in terms of legislation for this, is right and proper. It may be just my final point, Presiding Officer. Jenny Marr began her contribution with a question regarding SSC triple and the disciplinary aspects. Obviously, the bill was not enforced yet. If there is a situation that persons are facing disciplinary action through SSC triple, can I say of someone who used to manage in the care sector and had occasions to take people through disciplinary to SSC triple? It is a very rigorous thing, but it is there not to punish, it is there to identify whether a person has created or has been taken forward by their management because of disciplinary action. I would just be wary of trying to assign the SSC triple and disciplinary aspects alongside the bill. Thank you very much, Deputy Presiding Officer. I welcome the opportunity to take part in this stage 1 debate. I thank the committee, the clerks and various people who have given evidence at this stage. It has been quite an interesting debate this afternoon. We have put some differences of opinion and people have brought their own personal experiences to bear. I have come to this relatively fresh, because I am not a member of the committee. I had an open mind on e-cigarettes or NVPs, as they are known, coming into this debate. As the debate develops, I was quite interested and persuaded by some of the points that Stuart Maxwell was making in terms of cautioning on the use of e-cigarettes and some of the promotional activities of the companies. I then listened to my colleague Malcolm Chisholm. I listened very carefully to Malcolm Chisholm. He pointed out that it is important to look at the evidence. I looked through the stage 1 report and looked at some of the evidence. I noted from Ash Scotland's submission that there are 2.6 million people using e-cigarettes and 1.1 million of them were using it as a vehicle to move off smoking. The bottom line was that 2.5 million people from that evidence seemed to be using it as a vehicle to come off traditional tobacco products, which would seem to back up what Malcolm Chisholm was saying. I still stand by some of the cautionary comments that Stuart Maxwell and John Mason were making in terms of some of the activities that those companies use to promote e-cigarettes. I note the arguments that various members have made about how important they are in terms of allowing people to come off traditional tobacco products. Kevin Stewart is not here, but he gave personal effect to that. It is early days yet and we have to be wary of the evidence. John Britton, who is from the UK Center for Tobacco and Alcohol, is also a long specialist who said in evidence to the committee previously that vapour in vps have the potential of saving tens of thousands of lives, and the real enemy is tobacco. Nicodin is about as hazardous as caffeine. I take on that point. I acknowledge the overall benefits of e-cigarettes in allowing people to come off traditional tobacco products, but, ultimately, when bringing it back to the provisions of the bill, why do we have to limit sales? Why do we need a register? Why do we have restrictions in relation to vending machines? Ultimately, e-cigarettes are still a tobacco product. It would be better for your general health if you were not smoking either e-cigarettes or traditional products. In relation to the bands on smoking in designated areas at NHS grounds, I support that. It always seemed quite odd when you go to hospitals in recent times, since smoking bands have been introduced throughout the country. You see a lot of people outside smoking. I was taken again by Kevin Stewart's comment that I am not a smoker, and he said that when you go outside to smoke, you do not just have one cigarette, you have two. I was not even aware of that. Again, people being able to smoke outside hospitals encourages that. It mitigates against the overall aim of reducing reliance on tobacco. I think that there are practical considerations to be taken into account. Obviously, if you have a strict designated no-smoking area where it is an offence, and then you have other areas where there is a no-smoking policy where it is not an offence, people will soon get wise to that. There might be some difficulties in implementing that. I am also interested in going back again to NVPs and the fact that it will be down to individual health boards to decide the policy in relation to whether NVPs or e-cigarettes can be smoked outside hospitals. Again, I have to be honest that I am not totally comfortable with the idea that we are trying to stop people from smoking outside hospitals, but we might allow them to smoke e-cigarettes. I am not persuaded by that argument. In relation to some of the other provisions in the bill, the duty of Canada, that makes absolute sense. The points that people have made about being open and transparent are correct. I agree with what Kenny Gibson and Stuart Maxwell said. In some of the constituency cases, I get that there is almost a defensiveness from the NHS. If they feel that there is a danger that they are going to get sued, they will not communicate with you properly, and I think that that is wrong. If something goes wrong in a situation in which people are vulnerable, we do vote to them to be open and transparent, and we do vote to them to give an apology where that is appropriate. Again, on the criminal offences, that is also correct. Some people have said that there is a potential clash with the duty of Canada, but the provisions in the bill are quite specific about ill treatment and willful neglect. It also plays a particular role in care providers, and that is important. I think that there are some other issues to be dealt with in the care sector around training of care staff and appropriate payment to care staff. A lot of care staff are not on the living wage. Although it is not a specific issue in the bill, I think that that is something that needs to be addressed. I will round up the Deputy Presiding Officer and support the general principles of the bill. I think that there are some issues here that the policy intent is right, but I think that there are some practical issues that need to be considered in stages 2 and 3 of the bill. Thank you, Presiding Officer. Let me just nail my colours unambiguously to the masters that I have in previous debates on tobacco. In the 20th century, more people were killed by smoking tobacco than died in all the wars of that century. That is a vile trade that should not exist in the 21st century. However, those who have, to quote James The Six 400 years ago, been by custom in peace and peace allured to depend upon nicotine, tobacco for daily relief from the stresses of life, are not the people whom we should be attacking in this debate and I do not seek to do so. They are the victims, they are not the cause of our problem. The bill that is before us addresses the issue of advertising and promotion of nicotine vapour productions. Although I welcome restrictions on a product that is certainly known to not be carrying many of the chemicals that are present in cigarettes and cause ill health and death, it is nonetheless not capable of yet being shown to be entirely safe to be sold. The US Surgeon General's report of 1989 identified 400 separate chemicals in cigarettes, at least 40 of which were carcinogens, many of which were mutagens, many were developmental toxicants. At this stage, it simply is not clear whether we have the level of knowledge about vapour products and the chemicals within them, either individually or in combination and perhaps more critically when subjected to heat as to whether we are doing similar problems. Indeed, James Kelly quoted Ash, another quote from Ash in the committee's report, that identifies that butterscotch with diaceto and cinnamon, when they are heated to high temperatures, can be another factor in creating harm. When you take what might be innocuous chemicals and heat them, you can end up with something that can be quite toxic. However, if NVP's reduce harm enables people to move away from the very well-known, well-understood problems associated with nicotine addiction, then fair enough for the time being unprepared to accept them. I want to talk a fair bit about the duty of candor provisions and, in particular, I am going to get all techy about the way in which the bill is actually drafted, because I think that there is considerable confusion in the drafting about who persons are. The very first words in the duty of candor are, a responsible person must follow a duty of candor. And yet when you go and find what the definition of the responsible person is, the one thing you discover it isn't is a person. There are six different lines in the definition, a health board, a person brackets other than an individual who is entered in a contract and so on. None of those people are capable of being a person. So I think that it might be quite useful if a different term were used, perhaps responsible entity might be an alternative definition. Now I'm not just trying to pick at this for the sake of it, it's because person is used for other purposes in this section and I've identified three other purposes. For example, if we move on to subsection 2, this section applies to a person to whom something may have happened. But then at subsection 3 it suddenly switches, instead of saying person, it says individual when it's clearly talking about the person that you've been referring to in subsection 2. And if we go down to the duty of candor procedure itself at section 22, actions to be taken by the responsible person, we then get a relevant person. But this relevant person appears to be a real person who is an individual, not a responsible person who isn't an individual. And in 222C we've got the responsible person has to offer and arrange a meeting with the relevant person, which is highly confusing. And it gets even more confusing if we move on down to the definitions in 2. G, where responsible person has to make available or provide information support to persons plural affected by the incident, and yet it's not entirely clear who these persons plural might be, are the individuals or responsible persons. And then even more confusing, one of the duties, training to be undertaken by a responsible person. But a responsible person is specifically not defined not to be an individual. So how can an entity that's not an individual undertake training? I'm really not at all certain about that. Now, that's a little rant about that subject. But let me move on perhaps more significantly to reporting and monitoring. And in particular, where there have been failures, a report has to be produced. And the second part, 3B under 24, it cannot contain any information which is in the responsible person's opinion is likely to identify any individual. Now, I am genuinely uncertain how that can sensibly be done because we're looking probably at comparatively small numbers of incidents and in particular small numbers of incidents of a particular kind that maybe have to be described in the report. And I'm very uncertain that it will actually be possible to produce a report which has to be published, which will not lead it to be possible for that person to be identified. In our statistical analysis across government, we in general terms don't report below levels where there are five people involved to avoid that particular duty. Now, responsible person, oh by the way, responsible person, even though the offences can cover an individual or not included elsewhere. Now, Presiding Officer, just in conclusion, I just want to go back to a quote I used in 2004 when the then First Minister brought forward a statement on tobacco, quite the best thing that he and his administration ever did, unambiguously, and I continue to praise them to the hope for that. But James The Sixth said of tobacco, a custom loathsome to the eye, hateful to the nose, harmful to the brain, dangerous to the lungs and in the black stinking ffume thereof, nearest resembling the horrible stig doing smoke of the pit that is bottomless. We've known tobacco as an evil poisonous material for 400 years. Why are we still debating the subject now? Thank you very much. And our final open debate speaker is Richard Lyle. Thank you very much to begin since we're all being honest. I am a smoker. I started when I was 12 and I still smoke. That is my choice. I support this bill and comment on the bill as follows. The use of nicotine vapour products, MVPs, has grown significantly over the last decade. The health benefits and the health harms of MVPs are the subject of much debate, but research evidence for either is currently limited. That presents an overwhelming social and moral case for continuing research and debate in the subject. It is important to look at both sides of the debate. While some argue that MVPs are an effective tool for quitting or cutting down, as already has been said by my colleagues on smoking, others have concerns that they may be a gateway to smoking, particularly among young people. That has led to calls for greater regulation of MVPs. Let me be clear that I support the use of MVPs but also want to know what's in them. The health tobacco nicotine and care of Scotland bill takes this uncertainty and adopts a somewhat precautionary approach to MVPs. The bill proposes a number of restrictions on the sale, advertising and promotion of MVPs, which include a minimum purchase age of 18, the power to prohibit their sale from vending machines, making it a fence to purchase an MVP on behalf of someone under 18, proxy purchasing, an requirement for MVP retailers to register on the tobacco and nicotine vapour product retailer register, an requirement that registers retailers should operate in age verification policy, and the power to restrict or prohibit domestic advertising and promotions. 61 per cent of respondents to the Health and Sport Committee called for evidence supporting all of the provisions relating to MVPs. Notably, there was most universal support for restricting the sale to over 18s. One of those supporters is the British Medical Association, the BMA, in their briefing for stage 1 debate. The BMA fully supported an age restriction for the purchase of e-cigarettes and the refills and agrees that they should not be sold to anyone under the age of 18, which is in line with the current tobacco regulation. The BMA also supports the provision that makes proxy purchasing of nicotine vapour products and offends. One point that the BMA mentions in a briefing that I agree with is the appeal of MVPs to children and young people. Doctors have expressed significant concern over the proliferation, promotion and increasing availability of MVPs in the form of e-cigarettes and how they have the potential to increase the risk of children and young people using tobacco. According to the British Medical Association, it is estimated that a number of 11 to 18-year-olds in Great Britain have tried e-cigarettes, increased from 5 per cent in 2013 to 8 per cent in 2014, though regular use has remained low. I would like to turn next to the provision with the most opposition. The plan to give ministers the power to restrict domestic advertising and promotion of MVPs. Those responses have argued that that would be disproportionate to their harms and they would potentially undermine the public health benefit such as a smoking cessation tool. According to the BMA, analysis of the growing market for e-cigarettes has shown that marketing targets to distinctive audiences. Current smokers who want to use MVPs as a cessation tool and children and young people are non-smokers must be distinguished to two audiences. On the one hand, we favour current smokers who want to use MVPs as a way to try and quit smoking, but on the other hand, we cannot allow young people to be persuaded to use MVPs, especially if they are non-smokers. A review by the United States Senate in 2014 concluded that e-cigarette companies are employing the same marketing tactics that the tobacco industry first pioneered to attract young consumers to their products. I would now like to move on to part 2 of the bill due to Fcander. At the moment, NHS boards are required to implement learning from adverse events through reporting and review. That framework sets out a national approach to identifying and reporting and reviewing adverse events and is drawn from best practice. Following a number of reviews in England, there have been calls for greater candor among health and care organisations when things go wrong. As a consequence, the bill proposes to give health, social care and social work organisations a duty of candor. What that would mean is that, in the event of a person experienced or could have experienced an unattended or unexpected hand from their care, the organisation would have a duty to tell that individual. The bill proposes to give a duty of candor to responsible persons. I think that Mr Stevenson explained the situation in regard to that. Who are defined as NHS boards? Anyone other than an individual contracted by NHS board to provide a health service, GP practice, community pharmacy? Anyone other than an individual providing independent healthcare services, a local authority and anyone other than an individual who provides a care service or social work service? In the event that a person in the seat of health, social care or social work services experiences an unintended or unexpected incident, which, in the opinion of their registered health professional, could have resulted in a death or harm. Those in support of that measure, around 58.5 per cent of the respondents to committee's call for evidence, felt that a duty of candor would engender a culture of openness and learning, whereas critics argued that legislation was not the appropriate approach to create an open culture and defined harms were very broad and could have encompassed very minor events, therefore resulting in a significant drain on resources. Organisations such as the Royal College of Nursing support the creation of a legal requirement for health. I want to conclude, Presiding Officer, by highlighting some of the key features of the bill. The health bill aims to control the sale, advertising and promotion of 19 vapour products, such as e-cigarettes by a minimum purchase in age of 18 having the power to prohibit their sale from vending machines and make it an offence to purchase an MVP on behalf of someone under 18. We cannot allow young people to be influenced to start using an MVP. We can hope to educate them so that, when they matured, they can make the right decision. The bill also makes an offence to smoke within a designated zone outside an NHS hospital site or an entrance. I welcome that, but I also want to make the plea that boards do allow people in certain areas in their hospitals, as we need to steadily educate people who do smoke in order to eradicate that bad practice outside hospital doors. At 2 o'clock this afternoon, in his Thought for Reflection, Father Jeremy Bath hoped that our afternoon would neither drag nor fly by. I can assure him that it has not done the latter. As to the former, I will leave others to decide. I congratulate the minister, and, in particular, Duncan Neil for detailing to the chamber a comprehensive and interesting committee report on the legislation. Of measures that were brought before us, I am overwhelmed by a lack of enthusiasm at the moment for the legislation that we are considering. I wonder whether it all went away and whether the public good would be adversely affected. I am un-presuaded at the moment, although, on balance, we are going to support the bill tonight. I hope that, as it goes through its various stages, some of the concerns that have been raised will be addressed. I have a lot of sympathy with part 3 of the bill. I think that there are specific examples that we can think of where the willful neglect has not been effectively dealt with. I think that the Government's proposals in that regard are to be welcomed, although there are questions surrounding them. I thought that Jenny Marra and others spoke to the issues relating to the duty of candor with some conviction and credibility. I think that there is a lot more that needs to be teased out in the detail of that, but I am going to speak principally on the e-cigarette element of that. When I say that I am un-presuaded, some members may realise that there is something of a division between the net mill and myself at this stage, as we consider the debate, at not quite of Corbanista proportions. We are on the same path, but not yet at the same destination. There will be no need for a free vote. We will come to a unified position and due course. I thought that it started off for me with Duncan McNeill, who was going through the various devices that there are. My recollection when we first debated this was that my primary concern initially was the health risks associated with the delivery devices of e-cigarettes, where we knew that they had exploded in people's hands and where some people were ingesting from aldehyde and various other things. I know that the responsibility for that lies elsewhere, and I hope that all the work that needs to be done is being done there, because some of the reports that we heard from the manufacturer of these devices and some very unregulated markets finding their way into the United Kingdom and into the people who are utilising them was of huge concern. However, as Duncan McNeill talked about, I still find the sight of people using these vapour devices strange. For me, I do not know how many of a certain vintage may remember Christopher Lee as Fu Manchu in the 1960s. He used to use what looked like one of those devices to me, and I have always kind of associated it as a slightly strange, kind of cultish-looking practice. Nonetheless, it has become more prevalent. What concerns me about the mood of this debate is that we overstate the concerns. I think that I come to where Malcolm Chisholm and Kevin were on this. I support the issue in relation to vending machines to under 18s and to the register, but I am not worried that the lack of evidence was at times being used in this debate as an assumption that there will be evidence yet to be discovered and forthcoming, which is such that we should be putting a wall up in front of these products now. My concern when I heard Stuart Maxwell is that there are all sorts of habits that are more deadly and dangerous to public health, on which we are not legislating, than the one that we are. That is not a reason not to be precocious, but I will shortly. I heard him talk about the manufacturers of these devices, the cell as being the tobacco version. I heard Christina McKelvie say exactly that. I have always felt that Christina McKelvie can see a conspiracy in a vase of flowers, but here is an inconvenient truth. The people who are buying up the companies who manufacture these devices are indeed the tobacco companies, and there is a conundrum, because if in fact e-cigarettes potentially can save the lives of tens of thousands of people, there are people dropping dead of traditional tobacco smoke and there are hundreds of thousands today, and there are not people dropping dead of e-cigarettes. If in fact it is proven in due course that the harmful effects that Mr Maxwell thinks we should be taking precautions against do not transpire, then I do not want us to create an atmosphere and a hysteria and a tone around e-cigarettes, which is potentially prejudicial to what in those circumstances should be our objective to promote them aggressively to those who currently smoke to get them off traditional tobacco and perhaps contribute to save their lives. The uncomfortable truth about that would be that that would be to the benefit of the profits of the tobacco companies who own the devices. I am uncomfortable about that, but rather they made their money out of e-cigarettes than they made their money out of traditional tobacco, which is undoubtedly killing without argument, Mr Maxwell. Surprisingly, it may seem to the member that I agree with him, because the point that I was trying to make—maybe I did not make it well enough—is that I have no problem in supporting the use of e-cigarettes as a cessation product for those who are currently on tobacco. I think that that is a good thing. My concern is about the long-term consequences of the use of them, some of them have been mentioned, and also promoting it to young people as a fashionable habit that could take up. In that sense, I can say that we are agreed. I am just worried that we do not over-egg the mood music around which we discuss them to create a prejudice that actually makes people equate those products at the present time with traditional tobacco. May I say just in the final few seconds that Effications is a delightful member of the SNP, Mr Gibson, who has a ballot paper in his possession in the list-ranking election, that the rules that I drew up forbid any member from soliciting votes, so of course I cannot do that. I would say to Mr Gibson, who, like me, is of a certain age, falling into corpulent middle age as we both are. There is still a place for people of our age in this Parliament, but, of course, for him to complete that ballot, he would have to sign a pledge of allegiance to truth justice in the Conservative way, an obstacle that may be insurmountable to Mr Gibson. The Conservatives will be supporting the bill at its first reading tonight. I welcome the bill and I am supportive of the direction of travel within the bill, but I echo some of the comments made by Nanette Milne when she spoke about the minister's response to the committee, not on coming until late yesterday afternoon. I know that there have been occasions in which the Government's response to the committee report has not come before the debate, but we are pushing through a lot of legislation through the Parliament, especially through the health and sport committee. It is important that that legislation is well scrutinised, so it is important that we get responses from the Government that give committee members time to consider that. Even the minister's announcement today that part 3 of the bill will not extend to children, but we will be given the reasons for that in a couple of days' time. I think that we need all that information, because pushing through legislation we have to make sure that the legislation is good, that it is fit for purpose, otherwise we all fail. Even when we are supportive of the legislation, it is important that the Government give us the information that it requires. I will possibly turn the bill on its head as I address the comments that were made. I will first turn to ill treatment and willful neglect, and I echo Jenny Marra's comments about health and care workers, who do a tremendous job in very difficult situations. Although we talk about those issues, we have to remember that we hear of an unfortunate but small number of cases where patients have suffered ill treatment and willful neglect, and we need to deal with those who are leaving no chance of recurrence and make sure that the people who do that are treated appropriately under the law. There is a concern in the bill that the bill deals with a duty of candor and deals with ill treatment and willful neglect. Other speakers have made the point, but I reiterate the point that those two things are not connected in any way. A duty of candor is to deal with mistakes where no harm was intended. The ill treatment and willful neglect clause in the bill is where people have willfully neglected a patient and have taken steps, almost premeditated steps, to make sure that they are not looked after. Too often we pick up the newspapers and read stories where care homes have been abysmal. In those cases, it is because of a lack of trained staff and the owner of the establishment needs to be prosecuted rather than the staff. If staff are found to be guilty of ill treatment and willful neglect because they have not been trained properly, they have been understaffed and have not received support, that should not be the case. That should go back to the person who is managing that training rather than the staff themselves. I assure the member that that part of the bill on ill treatment and willful neglect, which are well known in legal circles, is not about people not being able to do their job because of different circumstances. It is where a person intentionally sets out to harm or ill treat somebody. The point that I was making was that that intention is by a care home owner, for example, who understaffs a care home leaving a member of staff unable to give adequate care to a patient that must be the care home owner that is held to account rather than the member of staff who has been trying, maybe, under the best of their ability to cope in a bad situation. Too often we find serial offenders here. People who own multiple care home licences, when they are found to be wanting at one, we need to make sure that all their licences are revoked as part of that. That could be an amendment at stage 2 or 3. That said, there is wonderful practice that we need to make sure is continued through all our care home sector and that patients are looked after. I turn to the duty of candor, which, again, is very different from the willful neglect clause of the bill. A point that I would make is that it is very complex. Stewart Stevenson talked at length about the procedure for how that happens. I think that it is important that we have some clarity as to how that would happen. For example, organisations are like a GP who is working on their own and provides independent input. If somebody other than the person who has been seen to have made the mistake apologises, does that break down the relationship between that clinician and their patient? Would it not be better for the person, if appropriate, who has made the mistake to make that apology? I would also make the plea that candor is important and should run through all the interactions that health and care professionals have with patients and clients. I think that patients need to be very clear that, if something happens to them, regardless of a serious impact or not, they are told. I take on board what Malcolm Chisholm said about a patient's right not to know. That is up to the patient. The fallback position should always be that a patient knows if something has gone wrong, regardless of whether they have suffered ill effect or not, so that they are aware of what has happened with them. Can I turn to smoking in hospital grounds on another issue that has a lot of debate today? We are still looking for some clarity about that. The Scottish Government suggested that it could be between 10 and 15 metres of buildings. We need to be much more clearer about that. What would happen if the boundaries to the hospital grounds were less than 10 or 15 metres? What would they be covered by the ban as well? I also want to bring to the Government's attention the part of the bill that talks about permitting people to smoke in hospital grounds. I would be pleased if the minister would put on record that a member of staff who takes a patient out, if they feel that, is in the best interests of their patient and important to that patient's wellbeing, that if they take them outside to smoke, they are not on breach of that and will not be disciplined for it. A clinician or a nurse's first duty is to their patient's wellbeing, and that legislation should not overturn that. There might be only a very small number of incidences where that would happen and be at the wellbeing of the patient, but we need to make sure that that is very clear. Can I turn to NVPs very quickly? I think that what was clear in the debate today is that they are 95 per cent safer than smoking, and smokers are 60 per cent more likely to quit when using NVPs. Those statistics cannot be ignored. I know that there is a huge concern about attracting a new brand of nicotine addicts, but if that gets people off the more harmful effects of smoking then we really have to see how we can encourage smokers to take up NVPs as an alternative but also take steps to make sure that young people and non-smokers aren't encouraged to take them up. With that, I would close, but reiterate our support for the bill and hope that it can be clarified and strengthened at stage 2 and 3. Many thanks. I now call on Maureen Watt to wind up the debate. Minister, you have until 5 p.m. Thank you very much, Presiding Officer, and I would like to thank all members for a very good and constructive debate on this very important piece of legislation. There are some issues that may need further consideration, but it is great to hear that there is support for the principles of the bill. Unlike Jess and Carlaw, who is underwhelmed by the bill, it is an important milestone. Measures to control tobacco, NVP products and smoking will play their part alongside the vast range of measures that will continue to be progressed by the Scottish Government to promote public health in Scotland. Part 1 furthers the aims of the Scottish Government's tobacco control strategy to support longer, healthier lives and to tackle the significant inequalities in Scottish society. I recognise that there is an on-going debate about the emerging evidence on the use of NVPs, and that has been highlighted in the debate. It is a relatively new product and research that is emerging all the time about the benefits or otherwise of it and who is using it and who is not. There is obviously a role for NVP products, but at the moment we do not know the extent of that role. There is research emerging all the time, and long-term research is obviously required, but we do know that NVPs are used, along with other sense cessation services, that are playing a key role in the field. The Scottish Government is working with NHS Scotland and NHS boards to develop a consistent approach on this. NHS Scotland last year issued a position statement on NVPs, and it is renewing it to take account of the latest evidence. Hanzala Malik highlighted the difference of opinion among members. On the one hand, we have Kenny Gibson, Stuart Maxwell, Jim Hume and John Mason are doing caution. Excuse me, minister. Can members come into the chamber and please do it quietly? Thank you, minister. Argin caution and not wanting to create a new generation of smokers through NVPs. On the other hand, we had Kevin Stewart, an advocate of NVPs, which has helped him to stop smoking and Malcolm Chisholm supporting that. However, we absolutely do not want to demonise people who use e-cigarettes. There is nothing in this bill that suggests that that is the case. The bill is an attempt to balance, to protect young people from taking up smoking and normalising the habit of smoking, but also allowing smokers to switch to e-cigarettes. That is the balance that James Kelly highlighted. It is a balanced approach that is welcomed by stakeholders, including Ash Scotland. We need to reduce the visibility and the appeal to young people and smokers while not reducing the potential of the benefits to current cigarette smokers. I welcome the health and sport committee's support for such an approach and know that many witnesses, as I said, have also expressed their support for the proposals. If we move to putting smoking outside hospitals on a statutory footing, it is an important step forward in tobacco control in Scotland. The Government has been clear that we will consider all the necessary action to see a tobacco-free generation in Scotland by 2034. Continuing to denormalise smoking in society will help us to achieve this ambitious aim. There have been diverging views as to how smoke-free hospital grounds should be achieved. However, most agree that sending a clear and consistent message that NHS Scotland is a health-promoting health service and that smoking on hospital grounds is not socially acceptable. There is strong public support for that. Health boards have had policies around smoke-free grounds since 2006, but they have asked us for a consistency of approach, and that is not without its challenges. John Mason asked about enforcement, and I say that local authorities already get £2.5 million to support existing smoke-free legislation. We have asked COSLA to provide us with information if they think that that will put extra pressures on them and how much extra money they would require. So far, we have not had any reply to that. It is about striking a balance in achieving our public health policy on smoking in a fair approach to patients and visitors. I take Rhoda Grant's point about the sensitivity for patients, but the legislation is in relation to persistent offenders. We are not talking about health workers in this regard in relation to mental health patients. Obviously, health boards recognise that particular point. We know now that smoking is not a reliever of stress. In fact, it can contribute to stress, and that is where making sure that every single patient is given the opportunity for smoking cessation services is really important. If I move on to the duty of candor, being candid promotes an accountability for safer systems, better engages staff in improvement efforts and engenders greater trust in patients and user services. I thank Jenny Marra for raising the point about disciplinary hearings, but the bill does not relate to professional regulations or the provision of legal aid for such hearings. The focus is on the organisational duty of candor and with respect to willful neglect and criminal offences. I will ask my officials to review the concerns and provide a response to outline the Government's position. We are working with professional organisations to ensure that provisions within the bill, including staff training and support, take account of staff experience and expertise, but they are not focused on enhancing working conditions where they have been unintended or unexpected. One moment, minister. There is far too much chattering around the chamber. We have been working with stakeholders to ensure that what is happening is that we focus on enhancing working conditions where there have been unintended consequences or unexpected incidents relating to harm. Jenny Marra, can we have a microphone on? Can we have your card in this? Apologies, Presiding Officer. I thank the minister for giving way. I wonder if she will be so kind as to look at the issue that I raised at stage 2 of the bill about many care workers being unrepresented legally and have no access to legal aid at the triple SC disciplinary hearings and will perhaps provide a response with numbers of those and arrangements for those to me. Thank you, Presiding Officer. As I said, I will look at what she says, but that has nothing to do with the bill. As I said, it is an organisational duty of candor, not in relation to individuals. The legislative requirement is to publish reports outlining the learning and change through the application of the duty of candor procedure. That will positively contribute to transparent, open and engaged public services that are committed to continuous improvement. In relation to using the negative procedure for regulation, the procedures will set out measures in great detail. It is not unusual not to have it on the face of the bill, but, as members know, it is done in detailed consultation and scrutiny of the stakeholders. In relation to part 3, the ill treatment and welfare neglect events in the bill will allow the police and courts to address those cases of deliberate neglect and ill treatment, which can happen in health and social care settings. Those incidences are rare, but are nevertheless a breach of trust and it is right that such behaviours are dealt with appropriately. Again, we will be working with partner organisations and stakeholders to publicise the offences among health and social care workers and providers, as well as those who receive it. As I want to reiterate that it is not intended to apply to mistakes, but it is to willful or intentional acts. If we look at existing legislation in relation to mental health, there is no evidence that anybody is being unnecessarily criminalised. The Association for Victims of Medical Accidents, representing people directly affected by harm, supports the bill. That concludes the debate on stage 1 of the Health, Marquine, Nicotin, etc. and Care Scotland bill. At the next side of your business is consideration of motion number 14200 in the name of John Swinney on the financial resolution for the Health, Marquine, Nicotin, etc. and Care Scotland bill, and I call on John Swinney to move motion. The question this motion will come at decision time to which we now come. There are two questions to be put as a result of today's business. The first question is that motion number 15003, in the name of Maureen Watt, on the Health, Marquine, Nicotin, etc. and Care Scotland bill, be agreed to. Are we all agreed? The motion is therefore agreed to. The next question is that motion number 14200, in the name of John Swinney, on the financial resolution for the Health, Marquine, Nicotin, etc. and Care Scotland bill, be agreed to. Are we all agreed? The motion is therefore agreed to. That concludes decision time. We now move to members' business. Members who leave the chamber should do so quickly and quietly.