 Good morning and welcome to the seventh meeting of the health social care and sport committee of 2024. The convener is unable to attend today's meeting physically and will be joining us remotely so I will be convening the meeting as deputy convener and I have received no apologies for today's meeting. The first item on our agenda is two evidence sessions on the abortion services safe access zones Scotland bill and as Gillian McKay is the member in charge of the bill Gillian will not participate in the committee's scrutiny of the bill by virtue of rule 9.13 alpha.2 brackets b. Therefore, Mr Ross Greer will attend in her place as a committee substitute by virtue of rule 12.2 alpha.2. Our first evidence session is to explore the impact of the bill for those providing abortion services and I welcome our guests to the meeting. All are here in person today. Professor Sharon Cameron, consultant in gynaecology and sexual and reproductive health, the Charmer of Sexual Health Service in NHS Lothian, Colin Pullman, director of the Royal College of Nursing Scotland and Dr Chris Proven, chair of the Royal College of General Practitioners in Scotland. Thank you very much for coming. Linda Hodges, representing the private hospital abortion services managers, was due to give evidence this morning but has given her apologies and we will therefore engage in written correspondence. We will move straight to questions from members. I would like to invite Ivan McKee to begin. Thank you very much, convener. Good morning, panel. A couple of areas that I would like to explore on. The first one was the more general aspect of whether you or your colleagues have encountered protests at the workplace and what impact that has or cannot have on staff. A general question, I don't know if you want to answer that in turn. I'm based in Chalmers, which is an integrated sexual and reproductive health service in Edinburgh city centre. It's on the site of the Old Royal Infirmary, beside a high school, university shops, busy road, buses, etc. It provides a whole range of sexual and reproductive health services, not just abortion care but also gynaecological services, menopausal services, comprehensive contraception, HIV care, gender identity care—I could go on. Since 2011, we have been providing abortion services to probably over 2,400 women in the region. The protests that we have had tend to occur on Monday mornings. They have been a group, maybe on average, for and rounded by 2018, increased up to eight individuals who would be standing or leaning against a wall on the public street separated from the patient entrance of Chalmers by a fairly busy road. They were men and women a little bit older in general, probably over the age of 50. The protests didn't occur every week. They took the form of a display of images, of fetuses, placards, anti-abortion messages. The protesters would sometimes walk up and down the street along the entrance into the Chalmers, the patient entrance, handing out anti-abortion literature to passers-by to those accessing the clinics and to the high school students in the adjacent school. The activity tended to increase during Lent in 2020. We had an octurnal illumination of images, anti-abortion messages, including a fetus projected onto the building. There has been a lullan activity and I have not been aware of any protesters since before Christmas. However, I can tell you about the impact that it has been having. Some of it is indirect through the impact that it has had on the patients, with women attending the clinics being clearly distressed, others phoning up in advance of a consultation because they are anxious about entering the building, they are worried about protesters, they are worried about maybe media being there, being filmed, being watched, some women who, perhaps by virtue of their way they dress, which might link them to a particular group or minor ethnic group, were particularly anxious about entering and feeling judged and being identified from the protests. Patient feedback that we were getting as time was that they were feeling targeted, anxious and harassed, so that was impacting on staff. Staff were concerned about the patients being feeling intimidated by the presence of the protesters that they may be less likely to access the services. Also, as I have said already, our service provides a whole range of services, including young people but other vulnerable groups, and they were worried that that might deter others from coming. The protesters are outside other clinical buildings such as the Dental Hospital and are adjacent to the IPOvillians, so there is concern among staff that they may be intimidating patients who might be deterred from using those services. They are in close vicinity to the public high school and are handing out distressing and false information. There is a direct effect on staff. The staff have felt frustrated about the presence of the protesters and that we are powerless to do anything about them. They feel frustrated that it is unacceptable that they are protesting about an essential healthcare service outside a healthcare clinic. As I have said already, they are anxious and concerned about putting off patients attending our services. It has resulted in additional workload for staff and logistical changes, not only the anxiety about preparing when we know that there are going to be protesters, but in some circumstances having to use staff to divert patients from the patient entrance to use the staff entrance. Of course, then, through the building, you have to use security cards and that can take up time and energy, perhaps having to plan for if there are going to be a lot of protesters present, whether women who are going to be collecting for example medication for early medical abortion, whether we might have to change where they have their medication pickup and we have had to spend time planning to look at other clinics where they might be able to pick up medication and also consider whether we use services such as courier services, which also has additional costs. There has been a lot of time and effort put into planning how to maintain activity in the face of those protests. It has also caused a chill in staff. Staff have been frightened at times about their safety and we are all well aware of cases, particularly in the USA, where abortion providers have been targeted and some have been killed and shot. Abortion care is already a stigmatised area. There is good evidence that staff that work in abortion services may not tell family and friends about what they do. That is adding to that and adding to staff feeling that their role is undervalued. As I said, it is already bringing patients in through staff entrances. It is all logistically challenging. Finally, we find that when protests are occurring, it may attract other groups who are well-meaning and want to come and protect the patients. However, the net effect of that is that you are then having two groups of protesters in a rather busy area. As I have said, there are buses, it is a busy street, there are other clinical services, and there is a high school next door. You can get the impression that you are working with a circus outside. Patients are not very conducive to patients coming in for their appointment for fear that their privacy may not be guaranteed. It takes some courage, particularly for some individuals to attend a clinic appointment in the first place. The protesters may be there on a regular basis for a spell and they may not come for months. I have said already that I have not been aware of any since before Christmas, and while that has been lovely and it has been great just to get on with business as usual, there is still always that niggle at the back of your head and that chilling factor. When are they going to come back? On the back of Professor Cameron, I mean, our members report the same. The real issues around about the unpredictability cause anxiety for people attending, especially in relation to the patient, but more in respect of our members in attending work. A number of reported to us is that they never get use to people being around, especially the leaflets and such that they are shown. That in itself is quite distressing, having to pass that quite closely, having to go to your work just to get on with your work to provide healthcare. Members report again that it is not happening all the time, but in some ways that makes it worse. That makes it worse that you do not have a predictability that is going to happen. Again, the impact it has on colleagues in supporting each other in relation to when it is happening and some of the things that are said and some of the things that are taken into the workplace. Of course, it creates an atmosphere in the clinics and staff report that that puts everybody on a bit of tension in relation to when they are providing care because that in itself is not good for the patients who are going through a difficult time. Of course, our access in healthcare is what they are doing. Our members just want to provide healthcare and the best that they can for the clients that they deal with. There is a direct impact. Professor Cameron has given me an absolute insight into the day-to-day of that. However, one of our members sticks to my head and says that he is always shocked and surprised when he is there. He is shocked, but he is never totally surprised, but he never gets used to it. It is just continually distressing and it wears people down, especially what is happening on a continued basis. We can never ignore the impact on the members of staff as well as the impact on the patients. I would like to support Professor Cameron's views and experience. I have not known any protest at primary care premises. The example that I am thinking of is the Queen Elizabeth hospital in 2018, where there were demonstrations outside where you could hear that in the waiting room. In this situation, women are going through complex emotions and should be able to lawfully seek healthcare in an atmosphere that is not tense with an atmosphere for patients with noise disturbance, so we fully support that. I emphasise the delay of women coming forward and it is best to go ahead in those situations as early as possible to prevent clinical complications and emotionally as well, most likely. There is not a clear definition now between hospitals and other healthcare premises, so we have to think ahead about what we define as a protected area, because often GP practices can co-locate with other sexual health services and we want to be able to allow patients to access all of those services. In Northern Ireland, I understand that they have a wider definition of areas that provide information advice or counselling, so we need to make that general point about where we cover and look ahead with it, so we anticipate where protests might occur. I have a couple of points to follow up on. Your reference to counter demonstrators was interesting in that regard in terms of the atmosphere that that creates. A couple of you mentioned false information being given out, so I would like to understand some examples of the types of false information that is given out in the protests. Usually the leaflets will show pictures of images of a very advanced fetus. That is very emotive. The vast majority of the women attending the services are coming at a very early stage of abortion and the leaflets will also have false facts about the long-term effects of abortion. There is good evidence and we have guidelines from the RCOG in Nice that have looked at the best evidence that show that there are no long-term effects of abortion in terms of no adverse effect on fertility or breast cancer, and yet the literature that is being given out will allude to facts such as that. The other question that has come up, and I just got some clarity on this, that was raised in the session last week, is the information that is provided within the clinics when the settings by staff are only options for patients for women coming in. If women are unsure of their decision, they have the option to discuss that further, to get support decision making support. For whatever reason, after an abortion, women may feel a variety of emotions, but there is also post-abortion counseling available through the NHS. The last point that I was going to raise was round about the exemptions on trade union activity picketing. Clearly, we are working our way through this, unless human rights challenges are on many sides. It is just to understand your perspective on the rationale behind a potential trade union exemption and what was in the bill with regard to whether you thought that that met those requirements, because clearly the right to trade union activity is a fundamental human right, as is the right to protest, so just to understand how we would not pick that in your perspective. I think that I will pick that up probably best. In respect to the proposals that are in the bill, and of course it covers predominantly picketing in the ability to be able to carry a picketing as detailed in the other legislation. I think that it could be looked at, it is written quite narrowly, and I think that you potentially need to look at the broader issues around about trade union activity leading up to, for example, a potential ballot, for example, or trying to engage with your membership. There needs to be some careful consideration of how that is being drafted, because it needs to be done in a very, and trade unions and professional organisations are very aware of where our members work. When we are actually doing trade union activity, we make sure that we are not impacting on individuals who are going to get care or whatever. That is very clear and very clear in our best-practed guidance and such like, but what we think that the legislation at the moment, as it is drafted, is probably too narrow. It just covers picketing in itself, and it should be able to look at the wider activity around about, especially building up to a potential industrial dispute, for example. Is there a risk that trade union activity can cause the same kind of concerns that we have identified on existing protests? I think that the issue is that the trade union activity is, of course, biased, because I am from a trade union and professional organisation. We are covered by very clear legislation that makes us behave in reasonable ways when it comes to conducting a trade dispute, and that has covered another UK legislation, which we, of course, adhere to absolutely by the letter. For the point of view of it, comparing it is very different in respect of trade union activities. Usually, we are looking to speak to our members, not to the patients who are coming through the front door. Just to follow up on that a bit, I acknowledge that those are different things and activities with different aims. However, if I reflect on what Professor Cameron said about women feeling uncomfortable that there might be media attention and cameras there, walking past any group of people could be a little bit distressing, no matter what they are doing. Can you expand a bit more on how union members picket a sexual and reproductive sex clinic? It has never happened to my knowledge. In my years in Scotland and across the UK, we have not actually picketed such clinics because there has not been a trade dispute. That does not mean that it would not happen. For picking to itself, there is very clear legislation on what you can do about egress access. The difference with respect to this is around the images that people put on placards and such. That would not be the case. You may have placards about issues with a message of more pay or whatever, but I would not compare the two. Just to press a little further, I will bring in Professor Cameron. The bill will include people who do not have placards that will include people silently doing their vigil or their praying or whatever they want to call it. It is still women having to walk through a group of individuals to access their health care. Do you have any comment on that, Professor Cameron? They walk up and down the street and approach people walking by. At times, I know in our service, they have come even into the reception. People coming know who they are and what they are doing, and that is distressing. If the media are going to be reporting it as the anti-abortion protesters outside the clinic and you are caught on film or you are worried that you are going to be caught, it does not matter whether they are quiet, they are doing these activities and approaching people, and their presence is a chilling one, and it is unpredictable. Just to declare my register of interest as a practicing NHS GP and particularly pertently at this, I am a member of the RCGP. I have basically the same question for Colin Hull and Chris Hull. Colin Hull, in your submission, it says that the RCN Scotland supports the intention behind the bill. Can I ask you clearly, do you support the bill as it is written? For example, we think that the clarification in relation to the activity around about the build-up to a trade dispute in a ballot needs to be thought about in relation to the draft but in relation to the bill and the principles of it and where the bill sits in relation to the exclusions that we do support it. Sorry, could you explain the ballot part of your... In relation to, if leading up so, it is very clear that the exemption is there in relation to picketing itself and that is very clear as it is described, but we believe that there needs to be some thought, so there is not any unpredicted unintended consequences. For example, leading up to within a trade dispute, you would generally go and speak to staff within that environment to talk about the trade dispute, the options and whether you were going for a ballot, for example, because you know we have very tight regional legislation that we need to go through in relation to carrying out industrial action, so you would want to have the ability to go and speak to staff to have that discussion. If it is as narrow as it is at this moment, we believe that there could be some unintended consequences that some employers, for example, could then turn around and say that you are covered under this legislation although it is not a trade union activity, that we are not protesting about the provision of the services or whatever, so that they could use that, they could misuse the potential in the act and that is why we think that the provisions need to be carefully considered when drafting. Chris, in your submission it says that the RCGP Scotland agrees with the purpose or the proposed bill, so the same question. Do you agree with the bill as it is worded? I think, yes, in the general principles of the bill, as far as allowing women, as far as women's health plan to have easier access to these services and not being discouraged from that and supporting staff. We fully support all of those aspects of it and also the type of silent protest. We really appreciate that that can be intimidating, so it is a difficult thing to define, but any sort of presence in that area can be intimidating and potentially will discourage when coming forward. I have mentioned about the definition of areas covered, because one of the consequences might be that protests move to other areas in primary care, after care and counselling and other services can occur there, so we have to think about that knock-on effect. Patients should also be able to access other services that are often co-located around sexual health services, rape crisis and counselling and support services. All of those other things, there should be no barriers to that, is what we put in the submission. I would like to pick up on a couple of Ivan McKee's questions. First of all, for yourself, on the question of impact on trade union activity short of picketing, except in what you said that none of us can think of an instance where there has been this kind of industrial action at a facility providing abortion services. In other settings where your members have taken industrial action across the UK, is it common to get complaints from patients about a perceived impact on them upon entering a facility if there is a picket line outside? Can you recall patients complaining about that? We have just been through an intense period of industrial action across the UK, and I have to say that it is a very reverse. Normally patients are very complimentary and very supportive. In the industrial action in England and Wales in Northern Ireland, I think that we had one situation where a member of the public took unbridge to people picketing, but there was no issues around about egress access. In fact, it was found because we investigated it further, so it is not something that has been an issue brought to our attention. Professor Cameron, following up on what you are seeing in response to Ivan around the support that is provided, those who engage in those protests say that one of their key reasons for doing so is that they are providing an alternative that they do not believe is provided within the healthcare setting, a discussion about alternatives to abortion. I wonder whether you could expand a little bit on your answer to Ivan McKee around the process and the support that is available to women who come seeking abortion services or reproductive healthcare services? We know from evidence that the vast majority of women know what they are going to do as soon as they have had that positive pregnancy test. We know that for women who come seeking abortion that most of them are sure of their decision, but there is a proportion that are not. Services do exist to be able to provide counselling to women who are unsure of their decision. We also see women who may want to end the pregnancy, but it may not be a pregnancy that is continuing. The services also manage women who present with—I will find out to have a miscarriage—many women decide that they are going to continue their pregnancy. The services support those women. That is one of the beauties of the Scottish NHS. We have all those links. We are part of the services that we have, sectionary product of health services, NHS services, good links with hospitals, some of the abortion services are set in hospitals and they are run by the departments of obstetrics and gynaecology. Often, it is the same staff that is working in early pregnancy units or working in maternity, depending on the size of the hospital. We have really good links. If people want to continue their pregnancy, we can support them in that decision. They can be supported to then access antinatal care for women who are discovered to have a miscarriage. We can support them. We can link in with early pregnancy units. For those who turn out to have a pregnancy outside the uterus and ectopic pregnancy, they can be supported to. That is one of the beauties of the Scottish NHS. We also have internal counselling services by staff who can provide support around decision making, as well as, as I said, for the minority of women who afterwards are struggling and need on-going support. It is a decision that, for many women, is one that they are sure of. For some women, it is one that they are not sure of, but they make that decision and they may later regret it, like many life decisions that we have to make. However, we have the services to be able to support those women both before if they continue with the pregnancy and after if they are struggling. Thank you very much. You mentioned the leaflet that committee members are aware of, the most common one that includes misinformation about things like risk of breast cancer. Have you seen examples of that having an impact, of that being handed to a woman who is seeking an abortion and your staff having to have a discussion other than the one that was expected, because there are concerns about the information in the leaflet? The staff have reported that there have been occasions when women have been upset and they have shown them the leaflet. That takes additional time to try to support them, calm them and provide to make sure that they are getting evidence-based true responses. They are not feeling intimidated, harassed into continuing with the pregnancy that they do not want to continue and that they cannot continue. Thank you. I am interested in your response to the claim that the protesters put out that what they are doing is providing alternative support and alternative information. I would clearly disagree with that. Often, patients come to us because they have an existing relationship and that is supportive for and after potentially counselling. Our role is to give the woman information so that, non-judgmentally, she can make that decision in her particular circumstances—on that particular one's individual circumstances and what she wants to do. Those protests contain information that is scientifically incorrect. We should prevent that so that we can have healthcare professionals who are trained and experienced in doing that. We should also do that in an atmospheres where it can, and they can think those things through rather than being anxious because they have been through a protest. You make a key point that the protesters outside are not themselves qualified healthcare professionals. We have probably all the answers to the question that I am going to ask, but just to make sure that it is on the record for committee, the introduction of access zones, what impact does it have on people accessing abortion services, people accessing other services at the facility and staff providing healthcare services and passerbys? What impact could it have? Staff are concerned that the presence of the protesters might be deterring individuals from accessing our services. Obviously, abortion services might be delivered in Scotland within a hospital setting that they might be delivered within sectionally productive health services. In particular, sectionally productive health services might be providing a wide range of services to a wide range of individuals with vulnerabilities, young people and just one particular group. There is concern that the protesters might be putting off individuals who might struggle to access services from attending. It is really important that we do as much as we can in Scotland and the rest of the UK to improve access to sexual health. The presence of protesters is working against that. It is also important that, for women who want to have an abortion, they can access that as soon as possible, because there is very good evidence that abortion at earlier gestations is associated with fewer complications and less pain and less bleeding, etc. It is also possible that the presence of the protesters might be deterring individuals from accessing not just the services within our building, but the services and surrounding buildings. We have the dental hospital that has been right outside. Are they putting off individuals accessing the dental hospital? Are they putting off individuals accessing care at the hypervillian? Are they putting off the passers-by? Are they causing them distress? We would hope that the bill would prevent that. To add to Professor Cameron's view, it is the whole issue of stigma and the impact that it has on patients. Professor Cameron is saying about people who are going there to access healthcare, but it is a difficult decision and it is a very emotional time for both the patients and their loved ones. Those kind of protests can have a potential impact. As I said before, it also has an impact on the staff on a day-to-day basis, having to go past. Naturally, it is made to feel that there is something wrong with the work that you are providing when you are only providing the best healthcare that you can provide in compassionate care for people. The whole issue is about the stigma that is made to feel that you are maybe not doing something that is worthwhile or whatever. That is how it comes across for people. That over a period of time can have quite a wear-in impact on people in relation to coming to their work. That needs to be understood as well as, as I say, for the patients. In relation to where services are placed, it could have an impact. At the end of the day, somebody may say that we are on and there is a protest there. I am due to get healthcare. I do not want to go near there for whatever reason. It is a very personal thing in relation to that and it is made to feel. Again, people might feel that they will be asked their views and that might have an impact on them as well. I would agree with what has been said. We want to improve access and prevent delays, especially for more vulnerable groups, which can be people from less well-off environments financially and rural areas. There is evidence that we want to continue to improve access around that and can interfere with that. The British Society of Abortion Providers pointed out that some women might be tempted to go on the internet and try to obtain drugs or go to non-regulated services, which we do not know what is in those medications. It is not a regulated service, so it is unsafe for them. In Australia, there is evidence that those types of schemes protect access, privacy, support staff and prevent misinformation. It is encouraging that there is some evidence around that. The clinical staff is also about support staff and administrative staff, and we should remember them as well. Thank you for being here today. You have already talked a little about other premises other than actual abortion provider places, so GP practices might be even pharmacies. Just to get your thoughts about the definition of protected premises, is there enough in the bill that could then be future-proofed or applied to other areas? Section 7 talks about extension of safe access zones and how Scottish ministers may approve an application made under section 1. Is there enough information that would allow further sites to be part of safe access zones? I am not sure that there is the answer to that. We want to be able to regulate in advance, in a sense, so that if the protest moves to a GP practice, which previously was not covered by the definition, we would have to produce more information regulation. We want to get ahead of the game. It is an area that needs to be looked at and to see what happens in other areas. I am not an expert in that, but it is something that we need to think about, because very often there are many other counselling and other services around that, which may be affected. The 200m radius that is proposed in the bill, I know that there will be places that would require wider than 200m or maybe different. Any thoughts about the 200m that is laid out in the bill? I think that flexibility is probably there, in some ways, defending on the individual circumstances of the healthcare facility and the situation. I do not know of the evidence around that, but it seems entirely appropriate. Other legislations have 150m or 50m, but 200m is what has been proposed in the bill. I suppose that there are any thoughts, Professor Cameron, about that, because you were talking about a really busy place or high school next door. That might be something that we have to consider. I think that it is important that the 200m would be a minimum and that there would be flexibility to increase that and to be able to consider new sites of delivery for motion care, technology advances, health service delivery advances, and there have been a lot of advances during the pandemic. It is not inconceivable that, in the future, some services could be delivered from general practice, which is a model in Ireland, from pharmacies, which is a model in Canada, particularly in remote and rural areas. We need to be cognisant and make sure that the bill is future proofed so that we are not in a situation where we are trying to improve access to those living in far away places. We find that the very healthcare delivery site that can provide them with their care is surrounded by motion protesters. I spoke about extension, but what about reduction of safe zones? I think that I read in the briefing that we need to be, I suppose, how would that work if there were certain future ministers that were against abortion? How do we make sure that the extension and reduction is going to be able to be continued and provide safe access zones? I cannot say that it could be reduced. Thinking about the services that I am familiar with, a 50m zone is far too short. I come in on that point about the zones and the extension of the zones. It is the point in relation to where, for example, an operator may not apply for an extension, and it is round about the trade unions and professional organisations having an ability to seek an operator to apply to a minister, to ministers for an extension, because I think that that might be important. It absolutely comes down to local situations, because, as we know, for example, the Queen Elizabeth, there are quite complex days around where the clinic is. It is not a standalone clinic, it is within a set environment, and those are the kind of things that we think that you should have the ability—from a trade union point of view—to have discussions with an operator of a service and an obligation for them in the legislation to consider that, to consider an application, if we were to approach them on that. Professor Cameron, you talked about women having to go in through the backdoor of a premise. The zone area that is defined in whatever place should include whatever detail is required in a particular premise to allow the ability to access safely, even through the front door, and not have to do the whole safe access, IG badges, escorting people through all of that. You talked about protesting outside potential GP practices. We all do abortion in some way, whether that is referral or asking our colleague to take a patient if you have a conscious subjections to it. If you were to have 200 metres around every GP practice, would that not be quite a lot? It is, and that is part of the difficulty for this bill that is defining that, because we all have some important involvement around the counselling around that. It is just bringing up that point for people to consider that balance around that and how far you go with it. That is why I said that I am not an expert, because I do not necessarily have a clear answer to that question, to be honest. However, we need a flexible way of anticipating and making that future proof. Where abortions occur in the future may be less definable, because often a lot of that can be done remotely or remotely, to some extent. I think that we have to be clear that GP premises are protected rapidly if protests are to happen outside them, but it is really up to the detail of how they do that. I hope that that makes sense. Can I ask any of the panel members about their opinions? We have our 200m zone, and the legislation that is put before us includes people's own residents as to what happens in their own residents. I would like to hear your opinion about the decisions, potentially, to start saying what people can and cannot do in their homes. Given that you are banning big pictures in the street and picketing a fetus, it seems sensible to include that. My understanding is that it is the only one that includes people's homes, but it is also somebody's own private residents. Your opinion is on that, please. My opinion is that it is a balance of rights and responsibilities. I think that it is women's right to have health care in a non-judgmental way without being deterred in any way from that, especially if there is a vulnerable situation for whatever reason. I think that we would not want a scenario where there are pictures put up in somebody's house because they are within their zone, so we would support the bill in that sense. Just to add to Chris's position, it is clear that there needs to be a balance between protecting the right for people who have a private conversation in their home, but there needs to be the balance of the right of the patients and the staff to access their services without seeing distress in images. For that reason, we think that the bill obviously attends to that. The other thing is the unintended consequence. If you were to make any other provisions around private dwellings, you could have people who tried to use that as a loophole in the legislation, and that would be something that you would really need to consider, i.e. a campaigner organisation from either side of the debate could buy a private dwelling and turn it into some sort of HQ, and that certainly would defeat the purposes of the bill. Just to add to that, I alluded to earlier during 2020 that there was a nocturnal illumination from across the street that was projected onto the building of Chalmers with the distressing images around a motion. I think that that would be covered in the bill that cannot be tolerated, and that was really distressing for the staff and the patients attending the services. I want to ask about criminal offences and penalties in the bill. I appreciate that it might not be your area of expertise, but I would value your opinions. Some opponents of the bill have raised concerns that the behaviour that is captured in section 4 of the criminal offences is wide-ranging and unclear. Do you have any views on the clarity of the actual offences that are described in the bill? I will go first. We do not have a view. It is not an area of expertise. Yourself as a Parliamentarian is probably a better view of that in relation to your wide view that you deal with, so I would not want to offer any observation in relation to it. It is not an area of expertise or knowledge. We have already heard about silent vigils and physically blocking people and those types of activities. We would support preventing those types of activities, although they are quite broad. I think that you have to be clear that that kind of silent vigil would still be very intimidating would be our view, so we support what is in the bill. Again, it is not my area of expertise, so we would defer to yourselves, but I think that for repeated offences that would be more serious. There has also been concern expressed from those who have experienced the regular abortion protestant in England that the fines may not be sufficient to deter those who are supported by well-funded anti-abortion organisations. That was quite briefly. I have alluded to in the session the different groups of citizens that access sexual and reproductive health. I think that it would be helpful to understand who is most impacted by the stigma and by being put off by which of our people. I am thinking back to when the FGM bill, the female genital mutilation bill, came through this Parliament and many minority ethnic women that we spoke with had trouble or found it difficult to access sexual and reproductive clinics just because of the bread services that they were offering. That group of individuals comes into my head when I think about people being put off, but I wonder if you could tell us about other groups. That group of young people, those who might not have the same skills to be able to navigate healthcare services, those with disabilities, and generally women living at a distance. I want to just come back a wee bit to human rights and I really value the views that you have given us so far because I think that that has come all the way through in the question, because of course it is important that we get this balance right for people. Am I right in saying that you feel that the bill provides the sort of a proportional balance between the rights of people to express themselves but the protection of people coming along to get what is healthcare? Will you say that the bill sets that out in a fair way? Yes, I think that we would support the measures in the bill. It is a really difficult one but I think that it is proportionate in the way that it has been laid down like anything that will be how the legislation is operated that will then prove through, but I think that with the way that it is laid down currently we believe that it is the right thing to do. That is helpful because the next point that I wanted to do is the 200m. We have had people discuss that operators of the bill should be able to increase it proportionally if they could. Some discussion about whether they should be able to be reduced in size. Do you have any view on that matter? I cannot see from this current time knowing the physical locations of services within hospitals and such reproductive health services that it could be reduced. One could imagine maybe in the future that if services ceased to be offered altogether then maybe that service might cease to be protected. However, it is more likely that looking ahead to the future and how service delivery and technology might change that there should be the flexibility for it to be expanded. Anyone else on that particular issue? I think that it is the point that the operator should have. I raised the point before that I think that it is two genes of professional organisations. We should have the ability to speak to an operator to look for an extension of it if we believe that there is a reason for that to be put forward. However, I think that it should be for the operators to make a decision in relation to specific circumstances. I think that it does come down to that circumstance in a way that somewhere is provided. I have one more question if that is all right, convener. I am interested to know some human rights organisations have suggested that on-going operators should have to make sure that the balance is correct and that they should be taking evidence from staff if there is any continual impact. How do you think that that would play out in the future if operators did have to continue to speak to staff and look at the impact of the on-going provision of the bill? I potentially think that operators should speak to staff anyway on a situation by situation basis to make sure that they are provided by the adequate support in relation to whatever is there part of it. As Chris Brown pointed out, it is not just around the clinicians who are providing the service, but it is a lot of other associated staff who work within services. Employers should have a duty to consult with their employees anyway around the impact of whether there be the restrictions that are placed upon it or indeed any of the demonstrations that take place. I would also like to add that it is really important that the requirements on the service are not administratively heavy. Already, the impact of the protesters—I have already alluded to the workload around having to consider how we might change our operations to be able to provide service continuity—takes away from clinical care. Some services are larger than others, such as Highlands and Islands. The service might be very small. It is really not fair to expect providers who are small in number or those who have large staff to spend a lot of time and put a lot of administrative work into continually reviewing and completing forms and putting forward applications. Particularly when we know that the protesters come and go, they may be there for a period of time and may not come for months. It is really important that it is as simple as possible. It really needs to be simple. It should not be the responsibility of the staff there. There should be a right to seek healthcare services for patients without delay and encouraging to reduce barriers there. I would not like to see having to prove that there is a problem before it is tackled. We should be anticipating it and preventing it in the first place. That is helpful. Thank you very much. Professor Cameron, this is a question that I will be putting to the solicitor who is coming a bit later. However, if you have something that is distressing or there are protesters, if this legislation is passed, somebody has to pick up the phone and call the police. Whoever that might be will have their name recorded. Do you feel that that might put off people or has put off people calling the police? We know from feedback from our staff that sometimes patients do not want to call the police even if they have been distressed by the presence of protesters because they will be linked with having attended the service in association with the motion. If it is a member of staff that calls the police, I cannot see that that would be an issue. Already staff feel frustrated that they feel that there is very little that they can do. I think that they would be accepting of calling the police if the legislation was breached. Is there any other matters that have not been raised by members of the committee so far that you feel that you need to express? Prior to abortion being legalised in 1967, it was a leading cause of maternal death. It is not anymore. I am particularly with the advent of medical abortion and good access. Women being able to have access to medical abortion at very early stages of pregnancy is an extremely safe procedure. The WHO says that it is essential healthcare. We need to protect access to this essential service. We do not want to go back in time and we do not want to go back to seeing women not being able to access this essential service. I think that it is really important to keep that in mind. I thank the witnesses for their contribution to the committee's work and I now suspend this proceeding. I call the meeting to order. We will continue our first agenda item today with a second evidence session on the abortion services safe access on Scotland bill. This session will explore the impact of the bill for those who will be responsible for enforcement and management of safe access zones. I welcome our witnesses to the meeting. Simon Brown, vice-president of the Scottish Slusters Bar Association, superintendent Jerry Corrigan, specialist operations G division at Police Scotland, Eddie Folland, chief officer of health and social care for the convention of local authorities in Scotland, COSLA. Lizley Sharkey, director of midwifery, NHS Tayside, and Sarah Wallage, lead condition for abortion at NHS Grampian. We will move to questions from members of the committee. I would like to start with a question to Sarah and Lizley, if that is okay. I am very much repeating, I am not sure if you caught this section of the previous panel, but I would be interested in your views around the misinformation that the protesters outside clinics share. The committee is aware of the most common leaflet, including misinformation around risk of breast cancer and the impact that that has not just on those accessing services but on your staff as well. Are your staff then having to have conversations to reassure patients about what they have seen in those leaflets? One of the core arguments that those protesters make is that they are offering alternative information on alternative support that they do not believe is on offer inside your facilities. Yes, it can have an impact on patients, not just for the protesters but online information as well. I would argue that there is thorough information available online, particularly with a new NHS informed information site. We do sometimes find that we are having to counter misinformation either with patients requesting abortion or with other people attending the service who mention it. I suppose that it is different from NHS Tayside's perspective. There is not a huge amount of protesters that are around that, and I am sure that we will come on to that from our area specifically, but the area that Sarah picks up, especially around internet and information that she can receive from other people and understand that the bill does not cover that part of it. There is a variety of sources that people can get medical information from nowadays, so we would always be able to direct that to the medical professionals or specialist nurses and midwives that are providing that service as well. Some of that is a bit of unpicking in societal attitudes around abortion and misconceptions that are on that as well, so it does have an impact around the country, but from a Tayside perspective, not a huge amount. You mentioned that protests are largely concentrated in Glasgow and Edinburgh, but because of social media and news coverage, people are aware of them across the country. Do you find that, even in facilities where protests rarely or never take place, are women seeking to access your services aware of it? Do they perceive a risk? Is there worrying concern on their part about the fact that they might turn up on the day that they need to access your services the day that 40 days for life are there? We have few protests in Aberdeen or Grampian, but we have had patients with their first contact with the service, which is a telephone call, and will there be protesters outside, so even though it is not happening locally, the fact that it has been reported and seen on the media is affecting people seeking to access the service. Very similar. It has been in a number of years now, from a Tayside perspective, where the actual protesters are outside the hospital or where the healthcare provider has been for abortion services. Societies have, I suppose, changed around abortion care. We heard in that first session for 50 years now, since abortion law has been in place and for people to be able to access services such as. One of the things that is really key and crucial for this bill, especially, is thinking about not just, we talked a lot and certainly in the previous session last week as well, we talked a lot about people accessing services right now, but what is the impact on people who possibly have access to services 30, 40 years ago? Who may still be holding some trauma for that for moving forward as well, whether it is the women themselves or its families that have been involved in that and being able to come into hospital premises and either being confronted by imagery or people who are protesting and what barrier does that put up? So, whilst we are protecting the abortion services right at the present moment and future proofing it, it is also the responsibility for healthcare for people who have already accessed our service as well. Thanks for your action. Just finally, if there is either a protest outside one of your facilities or the threat of a protest awareness that one might be coming up, what does that mean in practice for you? Do you have to do things differently? Do you have to provide different information to those accessing the service? What is the impact on you and your staff? How do you deal with either the protest or the threat of one? From a staff perspective, it is not just, I suppose, and it was picked up in the last session as well. We focus quite a lot on clinical staff who are actual providers of abortion care, but we also heard about admin staff, but I suppose from a porter and security staff as well, within hospitals, they would often be the first response or first port of call if there was any concerns around any protests or for safety of staff as well. We have to think about that and from a risk assessment perspective, what are the risks? The first port of call on the initial perspective for staff would be, as we have heard, phone the police, contact security phone the police and then we would be looking to our police colleagues if we got encouraged to be taken over that in the security aspect. Thanks. Anything else you would like to add, Sarah? Yes, I agree. There would be a risk assessment of how we would manage the protest. It affects the whole building, it is not just the abortion service, it is everybody else working in that building, which for us includes cardiology, physio, a huge number of people could be affected. Yes, involving NHS security and making sure that we have contact for the police when needed. That takes us neatly on to the impacts on Jenny, but we have colleagues who will be covering that. Feel free. In that instance, Jenny, a lot of this, when this became much more high profile, it has obviously gone on for a long time, but when this issue became more high profile over the last five years or so, initially the interest of campaigners was in speaking to both the police and local authorities about what could be done locally. The reason we have ended up where we are now is a general consensus, a belief that existing law and the existing powers given to councils in that instance was not adequate to deal with it. I wonder if you could talk a little bit about the response to that. Those who have complained about protesters to the police in the past, the response that they have received is that there is no current law on the books that they are breaching and therefore your officers are unable to take enforcement action unless specific behaviours cross a line. I agree that there is no existing legislation that deals with the ethos of what the legislation is trying to achieve, as it is trying to protect people who are legitimately accessing the healthcare services unhindered. Yes, there is legislation that if people go to those premises and protest across a line of what would be acceptable in terms of criminality, which is always going to be open to some sort of interpretation because it is going to depend on what the picture looks like, what the wording is like. There is a whole lot of circumstance that is really going to need to be considered as to whether a crime has been committed at that point. At that point, we can take action. I suppose that what I am trying to say is that when there is protest, when it is actually happening and there are specific behaviours taking place, then yes, we do have the legislation at that point to deal with that protest. I would say that what we do not have at the moment is legislation around that preventative element to create that safe space and for us to enforce that safe space, which would be through engagement and communication. I do believe that that gap does exist. At present, if the protest has arrived outside of facility, there are complaints that your officers are called. How would they deal with that under the laws that stand? Obviously, at the moment, it is entirely legal to stand on the road opposite the Queen Elizabeth hospital in Glasgow or opposite Chalmers and protest, but very regularly when those protests occur, your officers are called. How long would they attend for? What would they be looking for in that instance? Would they attend, speak to the protesters about what is and is not allowed and leave again? Would they stay for some time? Protesters, therefore, as it stands at the moment, your officers are presumer not going to attend the protests all day every day for 40 days. What does it look like when they are called out? When they are called out, the officers will attend and essentially assess what it is that they are faced with. If it is that small number of protesters that we often see around a dozen, it is peaceful. Generally, we are quite content to have that engagement with them, to find out their intentions and how long they intend to stay. We really get that feel that what we are seeing is that static peaceful protest. We would probably, at that point, be quite happy to leave them to it. Perhaps do some visit every two or three hours just to make sure that nothing has escalated. Engage with the premises to make sure that they are aware of the protest outside. If they see it escalating, then give them that reassurance that they can give us a call and we can take it from there. If it is peaceful, settled, static, generally we will leave them to it with a couple of safeguards in place in case it were to escalate beyond that. Professor Cameron gave us an example in the last session of images being projected from a distance but projected on to the facility. I understand that you might not want to talk about specific instances that have happened in the past but, as a generality, are your officers currently able to take any action in instances where somebody from a distance is projecting images of a foetus or anti-abortion message, whatever it might be, on to the face of a hospital or, potentially, buildings have windows. Some of those images are entering the facility. We could attend the premises from where something is being projected and try to engage with the householder or whatever it is and ask them to turn it off but it would be essentially voluntary. We would not have a power of entry in order to enforce that. That being said, probably as the legislation stands, I do not think that we would have that power either. We would need to apply via the Procurator Fiscal to a sheriff to get a warrant to enter those premises to either seize the equipment or to get it turned off. What if they were doing it from a public highway rather than from a private property? Yes, so that would be different. We could take action and seize equipment and consider the legislation of the bill as it stands at that point. However, when it is in that private property, unless there is a specific power of entry in the legislation, we would need to apply through Procurator Fiscal and Sheriff to gain access to that private property to take action. On that point of clarification, we have got our briefing notes and quotes from Police Scotland's submission in evidence. The bill has been reviewed and Police Scotland's position remains that existing person offences are sufficient to address unlawful behaviour that may arise in the vicinity of healthcare premises as a result of such protests. I suppose that I just want clarification on how that is because of what you just said to make sure that we understand for the record exactly what the position is. Is that okay? I was reading that. In our original submission, it says to address any unlawful behaviour. I suppose that the clarification for me to that is that we are going to change what is lawful. At the moment, standing silent outside a clinic is not unlawful. We would not be able to take action around that because it is not an offence. If we are trying to change what can take place outside a clinic in this bill, it makes that action unlawful. We do not have the powers to deal with that. I suppose that it is about tautology and it is about the statement of the obvious. I suppose that if it is lawful, it is lawful if it is not. I cannot see what you are saying, but I suppose that just the way that it comes across is a statement that you do not think more powers are required to deal with the situation. Thanks for that clarification. I am interested in issues around protected premises and the definition. I know that there is variability of healthcare provision across Scotland, so the 200-metre zone might need to be extended for certain parts of it. I know that COSLA's submission says that COSLA expressed support for the provision to extend safe access zones as necessary, but talked previously in our briefing notes about further stakeholder engagement to explore how information about protected premises and their surrounding safe access zones could be effectively communicated to interest parties. I am interested in any thoughts about the definition of protected premises, whether 200 metres is, in your opinion, adequate. I suppose that, Eddie, I will come to you first. I think that there is probably a need for a wide engagement in general terms for this. From a local authority perspective, the feedback that we got from elected members—we took that to two of our boards, the Communities Board, where elected members represent local authorities on the health and social care board. Their interest was in—there was actually a question about 200 metres enough, in some respects, but I know that there is a power in the bill to extend, if need be, depending on the circumstances in each particular area, which we would support as well. In general terms, we support that provision, but I probably do not have a lot of detail in the specifics. We heard in the previous panel that Professor Cameron talked about persons having to come in through a back door and get escorted, and then that is a whole issue of access to using IDs to open doors and things like that. As I suppose, Leslie, it would be your thoughts on the perimeter of establishing a safe access zone in order that people are not approached or harassed, which requires access through alternative front door entry. We were keen to keep it at 200 metres as well, and precisely for that point, because there are many accesses into different healthcare providers, and there is not usually the way of hospitals, as well as healthcare establishments that are built nowadays, and have been in the past 50 years, there are various different ways that people can enter. We would not expect people who were coming in for hip operations, for example, to be taken in through a back door, as you say, so why should we expect anyone entering any healthcare establishment for any access to services, not to come in the area that you would expect the public to walk into, because it gives the whole connotations around abortion services, if you go round through the back door, and different buildings have different entrances, and they may look different as you walk into staff entrances. They may not be as welcoming to the public, there may be storage facilities that are in, and for women accessing services like that, it does not give a value, really, around the healthcare that they are provided with, so that was why I think the key point as well about future proofing healthcare is expanding and is hopefully moving towards a place that is much easier in right care, right place, right time for people as well, and that does not necessarily mean that abortion services, as we have already heard, will always be within a hospital setting, certainly in Tayside, the majority of medical abortions, which is under 12 weeks and given by medication, are provided, the medication is provided and is undertaken at home as well, so whilst at the moment we provide that medication through a hospital setting, in the future that may not be, it could be a pharmacy, it could be GP surgeries, it could be clinics, it could be different kinds of providers that are moving, so I think we need to be able to protect those as well. Future proofing aspect of the provisions in the bill need to make sure that there is flexibility to allow, for instance, if GP practices or pharmacies or other areas could then be included based on application and then ministerial approval, so is there anything missing at the moment in the bill about expanding or even reducing premises, for instance? The flexibility is the key word that you talk about and probably the pace of what the application can be put to ministers and can be approved on as well, because I suppose what we don't know, what we don't know always, and whilst we are trying to future proof things, it may be that protesters decide other areas as well, such as GP surgeries and 200m round EGP surgery does seem quite a significant amount, considering who else would be entering the premises for those things and that right to peacefully protest, but if the pace of the application can be put through a rapid response, that would be flexible enough. I have some questions about criminal offences and penalties, which I think will probably mostly be for Jerry Corrigan, Simon Brown and a bit of other panel members. I wish to come in and am happy to hear from them. There have been some concerns raised from opponents of the bill that the behaviour that is captured in section 4 is wide-ranging and unclear. What are your views on the clarity of the offence? Section 4-1, I think that influencing is the one that will cause the biggest difficulties. I don't think that prevention or impeding would need much clarification and certainly harassment, alarm or distress would convene existing laws that we have at present. Influencing is going to cause a problem, and I think that on that basis, to make the legislation a success, you are going to have to focus much more on an exclusion zone and any behaviour within that exclusion zone being and offence if it is designed for the purposes of influencing other people. That should be relatively easy to establish because, by the nature, those people are coming to protest. While we are hearing the scare stories of someone who will be arrested for playing silent on the street, the protests that I have seen so far have involved placards and banners and posters because they are obviously trying to make a point. If you can identify somebody as making a point of a protest and you could identify them as making a point of a protest within an exclusion zone, then I wouldn't foresee a difficulty in prosecuting that. Speaking from a defence point of view, I think that that would be hard to defend. My sense is that, in reading section 4.1, to take that out operationally in terms of the protests that I have seen at the Cwunilys with, for example, it feels competent to take Simon's point about the word influencing. There is perhaps a bit of interpretation within that, but my sense is that it would take a bit of writing in the police report to the Procurator Fiscal to outline overall circumstances, for example, silent prayer, and how that could have the effect of influencing. It feels competent. On that point about silent prayer, we heard from the previous panel about how even that can cause distress and anxiety and impede people going into clinics. How would a police officer determine what somebody was praying about silently? I guess in terms of that and in providing evidence to the prosecutor in terms of what the person was doing, it would really just need to be a physical description of the person's demeanor as opposed to going into the realms of perhaps what they were thinking. Do the police Scotland have any concerns about enforcing legislation that was around what somebody was thinking? Yes, I am certain that that is not an area that we would go to or encroach upon or ask about or try to describe at all. That is an area that we would stay clear of. Do you think that the offences in the bill have a lower evidential requirement than in comparison to existing offences? The example was relating to harassment or threatening behaviour. My sense is that it is broadly comparable to the description of a breach of the peace or the statutory breach of the peace. In my sense, it feels comparable to that, so it covers it. Section 5 of the bill is going to create an offence relating to behaviour from property within a safe access zone but not covered by it, which could be seen or heard from the safe access zone. Are there any existing offences that are similar in nature? Do you have any opinion on the proportionality of that measure? I cannot think of anything that is similar in nature. If you are talking about the example that was given when I was projecting something into a building, I do not think that, as I said to talk about that specifically, that would still be an offence under the terms of the legislation because it is creating an influence within the exclusion zone because of the impact of the behaviour within the exclusion zone. I cannot think of anything as the law currently stands that where behaviour outside influences behaviour inside, there would be a crime, but I think, as Jerry says, if you look at the general terms of sex and third day, which is the statue of the beast or the breach of the beast itself, which probably in these particular situations would be more relevant because it is more of a subjective test from the complainer saying that I was placed a state of fear in the land. I think that a lot of the conduct that is envisaged to be captured by this bill would be captured by it. I think that, just to go back briefly to your earlier point as well about silent prayer, I would not anticipate that you are going to get people leading a defence of, I was not committing an offence, I was thinking about my shopping list. These are people who are here to protest, who are going to say, I was here to protest, this is what I was doing. Going on from that, these are people who will always take a case to trial, who I would imagine will not pay a financial penalty and will seek to be imprisoned to raise awareness of what they are saying. That is a likely outcome here. I was just going to comment on the point about items being displayed in private property. If there was a contentious march, for example, through a city centre and someone is displaying a flag of the opposing side in their private property, probably that is going to be an offence under breach of the peace. That is a specific legislation as such, but given the behaviour that it could incite within those in the march, it could be a breach of the peace. I suppose that it is not entirely unique. We heard on the earlier panel concerns that the fine element—I think that Simon alluded to this in his answer as well—could be paid by what are sometimes quite well funded anti-abortion groups, so that it is not going to act as a deterrent to any of the panel members who have a view on that. I will come to you first, Simon, as you mentioned it. That is almost certainly the case. I think that it is unlikely that any of these protesters will be paying it themselves, but to go back to what I said earlier, I think that it is unlikely that they will pay a fine. If you look back at the closest asset that you can give is the protesters against nuclear submarines, I think that some of them, to stop oil protesters in England and Wales, do not pay the fine because they will then be imprisoned for not paying a fine, and that gets your headlines off imprisonment for paying silently. That is the whole point of that. Does anyone else have anything to add on that? One final question. The Police Scotland response noted that the fine-only approach had implications for power of arrest. Could you explain, just for the record, what those implications might be and how that might influence decisions on enforcement of those laws? I note that the bill itself does not have a power of arrest or is silent in terms of power of arrest around protesters, which is fine, and that is something that we can work with. In my sense, the power of arrest is still there. The fact that it is a fine we just need to be considerate in terms of how serious the offence is when we are thinking about custodial outcomes from the police custody and whether they are going to court and how quickly that person is being released. Are you able to expand on that a bit and give an example? I know that it is difficult, because this is a new thing. Generally, we have a presumption of liberty. We try not to arrest either by using other means or by releasing people from custody very quickly. However, the protest is slightly different, because if we arrest someone at a protest, take them back to the police office and release them, then they can just go back to the protest. Obviously, that is not working. Probably, practically, if a person were to be arrested at a protest, we try now to keep them in custody until the protest itself is finished, certainly for that day, to avoid that instance where the person just goes back to the protest. However, we probably would not keep them in custody for court the next day, because I suppose the fine is indicating that it is a relatively minor offence. I think that that is all I want to cover. Sarah, can I start with you, if I may? I asked this question in the last panel. The reason I asked it was because I was approached by somebody who works within an abortion service. She said to me that she has, and those of other members of staff who have been put off calling the police because they do not want their names associated regularly with complaining and being out there. Is that something that you recognise as potentially an issue? I would not have thought so. When we were fortunate in Aberdeen, we had not had to contact our local police, but I would have thought that, if it is a staff member, it is part of the job. I wonder if there could be a possibility of being recorded as NHS Grampian rather than an individual staff member, and if there is any precedent for doing that, whether that would remove those concerns. However, I would have thought that our team would feel that that is part of the role to be on record of having made that call, whether we would rotate amongst us so that different people would call different times. We have not felt that that would be a problem. If the protest is happening, it is part of the job to report it. That comes on to my question to Simon and to Jerry. Is it the case that you have to have somebody down as the named person that has made the complaint? Or, as Sarah just said, could it be the department or the area or the place for this legislation? I do not think that you need a named complainer, but if the case proceeds to trial, you need a witness. You need somebody to come to court and say, I saw person X doing behaviour Y. In theory, depending on how the acts ultimately work, if the exclusion zone is in the exclusion zone and it becomes an offence to simply protest within that, then in theory, if you have good CCTV coverage and you can see that the person is within the zone holding a placard clearly protesting, that should be sufficient to run a prosecution, I would think. Looking at it from a defence point of view, I would find that hard to argue. However, if you are saying that someone was upset by conduct, then, ordinarily, in a breach of the peace case, you will need somebody to come to court and say, I was upset by that conduct. Yes, absolutely, but if it is a clear, if you turn up with a placard, let us say that there is no CCTV, but you do need witnesses, but could it be that the department makes the complaint and then the witnesses would be the people who would then come forward to further that case? You need to ask the fiscal officer about that to get about. Speaking from a defence point of view, I do not see how that would be difficult. For example, CCTV is normally presented as evidence and gathered by the local authority and it is normally agreed because the local authority provides a certificate to say that our CCTV operator took that CCTV. In theory, I could see no difficulty with just a named organisation saying that we provided CCTV, but if you are going above and beyond that, if you are talking about subjective conduct being complained about, you would need somebody to speak to what that conduct was. Likewise, we do not need a name if someone phones in. That is not required. I probably would also add that, if someone does phone, it can be anonymous, but if that person phones and says, 100m away, I can see 20 people gathered, they are probably not witnessing any one specific person doing anything. The reason I mentioned that is that when the police do arrive, it may be that the evidence for the prosecution is solely coming from the police officers, and it is not actually coming from the person that phoned in. Police officers will view CCTV and I have viewed the CCTV and I can see person A committing this offence and that is person A in court, so they do not have to actually see the offence itself. That would be competent. I just want to go back to the question about silent prayer, because we have already heard from questions that have been described to us at a previous session about the impact that that has had on people. If you are called to say that there are five people standing in a circle, how can you, as the police, deal with that if you are not going to ask them what they are doing and ask them if they are protesting and if they are praying? In terms of the bill, the police officer in the report to the procreator fiscal is probably going to need to describe the picture that we have illustrated there. The overall circumstances, the location of where the people are at, their demeanor, how they are standing, are there any other signs or placards, etc. It is really painting that picture of what the people are actually doing. I really do not think that we could go down the road of asking them what they are thinking or what their thoughts are. That feels really uncomfortable, even asking them why they are here at that point in time, probably from a defence point of view, beginning to question them, to try and complete the crime, which is also fraught with difficulties as well, because we are getting into the realms of interviewing them at the location without offering them legal advice or cautioning them. There are some difficulties there. Specifically about that, if one was stopped driving a car, is it that the police officer is not entitled to ask, do you know why I have stopped you? Is that not similar? Back to the protest, if we are asking them why they are there, what are they thinking? At that point we are beginning to gather evidence that is going to help with the prosecution case. Probably if a police officer stops a car and asks the driver, do you know why I stopped you, it is probably more of a conversational piece, as opposed to trying to gather evidence to complete the criteria of the crime. I suppose that the last question that I would like to ask is in your opinion, and this is very subjective, seeing as we have not done it yet, but in your opinion, do you feel that the bill, in the way that it is written, will provide women and staff who will be attending abortion clinics the protections that it intends to? If not, what would you like to see added or taken away? I think that the bill as it is written should go a long way to providing the relevant protections. I think that there will be practical things that will have to be done. I think that if you have got a clearly delineated exclusion zone, that will be a big help. As I already said, CCTV will be a big help. If you have got both of those things in practices, you should render prosecutions relatively straightforward. If you are asking if there is one thing that I could add, I think that you should be looking at something similar to the current provisions in relation to domestic abuse, where known harassment orders can be granted, because once you have had a conviction of a person, I think that you would like the position for the prosecutor to ask the court to impose an order on that person, not to go within an exclusion zone in any hospital for a period of time, and that would provide the police with a reason to arrest a person simply for being there without doing anything, and that would, over time, cut down on the number of protesters. I agree that it goes a long way to providing that safe space for women to access the services. Certainly, there were protesters at the Queen Elizabeth yesterday. I am sure that if the bill was passed and in, then quite frankly they would not be there, so I guess that there is a difference. Generally, the people that protest around this topic are law-abiding, so I think that they would take a licence of this and adjust their protest site accordingly, which would then create that safe space. Just following up on that point around silent prayer and intent, so that I am understanding that correctly, because what I am trying to figure out in my head is how unprecedented the proposals here are, because that is what some folk are making. The comparison that I was drawing my head and understanding that it is not like for light is around stalking and harassment. It is not illegal to stand silently outside somebody else's house, but if you are doing it as part of a pattern of behaviour where you are stalking that individual, I am understanding that that is already an offence under the law. So, police officers are already being asked to make judgments around intent and not entirely dissimilar circumstances or they are not? Yes, so I guess that the discussion on silent prayer, so I do not think that we can provide opinion. I think that we need to provide facts around about prosecution. So, I think that all we can really provide is a picture of what it is that we actually see. It is someone standing silently, solemnly and describing their demeanour, what their body language or what their body is actually doing. I suppose why, in terms of the bill, that would be intimidating for someone attending an abortion clinic and why that might potentially influence their decision as to whether they proceed with that and bring in the overall circumstances of it being the abortion clinic. I just do not think that we can possibly start entering into what that person's thoughts were or what they are. I suppose that I probably did not wear that particular wear. I appreciate entirely that, where the bill is to pass, it would be asking police officers to do something that is relatively difficult. However, the point that I was trying to get at is that we have not already asked that of the police in a range of other circumstances where there needs to be some attempt to understand the intent. I am giving an example of that. You can stand silently outside somebody's house since it is not a crime but if you are doing it as part of a pattern of behaviour where you are stalking and harassing the individual in that house, that is part of an offence. We already asked police officers to make those kind of judgments. In the first instance, we then asked Fiscal and the Courts. The harassment and domestic abuse is probably a good example of that if an ex-partner was standing silently outside somebody's house because that feels intimidating. There are comparisons to that. That is useful. That was partly just so that I could understand, in my head, with my lack of familiarity with other areas of the law just how unprecedented that is, but that was useful. David Orns. Good morning to witnesses. Mr Brown, this is for you. It is round human rights issues. Does the bill balance competing rights under a European convention of human rights and do you think it does it successfully? I would imagine that any final warning of the bill is going to be very similar to the legislation that was passed on Northern Ireland. The legislation that was passed on Northern Ireland has been tested against the ECH and the Supreme Court and the Supreme Court said that it is compatible. If it is similar to that, I fully anticipate that it will be. I cannot say that there has been a difficulty. The right to protest is enshrined in the ECHR, but there are limits placed upon that. As I said, the Supreme Court and from memory, there are at least two Scottish judges sitting in the Supreme Court. Lord Reid was sitting, Lord Galloway was sitting. He saw that the restrictions are appropriate in the context. The short answer is that, if it is in the similar form to the Irish legislation, I cannot say why it would not be ECHR compatible. I quickly go back to Salem Prayer, because I have a real problem with this. If a group is standing there and they are asked what they are doing and they turn themselves out on religious beliefs and praying for a man to marry or whatever, how are you going to prove differently? Are you ever going to get a conviction for that? That is true, but I think that, to go back to the analogy that Mr Greer used about stalkers, when I am a defence minister, I am not a prosecutor, but when I am defending somebody with those charges, inevitably the defence will be, I was not stalking, I was standing there having a cigarette, I was standing there checking my messages, I was not stalking. In these situations, I think that you are talking about people who are actively going there to protest and will accept the fact that they are there to protest. Otherwise, there is no point in doing so. I do not think that you are going to get people who are going to say that I was not here to protest against the boss and I will say that, as you said, to pray for man to marry or else what is the point of them being there? Whilst I can see that being, in theory, a difficulty in the particular circumstances that I think we are likely to be dealing with, I do not think it will arise, because people are going there to protest. They are going to say that they are there to protest. Ruth Maguire, do you have any further questions? No, sorry, I was just thinking there of it. No problem, Sandesh Gohani. Just for the record, if I, let's take the LGML case, and I want to go and protest outside the chestache side about Professor LGML or things that have been happening and say that this is unacceptable, I would be breaching a 200-metre zone, obviously, because I'd be trying to get as close to the hospitals as I can, but are you absolutely happy that that protest will not fall in any way under this bill? The actions influence people going for the bosses. They don't know why you're there, so if your actions influence them, then they might... I imagine that I'd have a sign about LGML. No, I don't think that there is a distinction. Looking at it from the person that's accessing the services point of view, their approach and the premises and probably all they're going to see from a distance is someone or other people with placards, and probably at that point they'll take it within themselves that that's what the protest is about rather than something else. I think that there is a difficulty if the protest is for something completely different. Thank you. That, to me, is a huge concern. It's obvious if you're going to the Chalmers in Edinburgh because there's only so many things that they provide there, but if I turn up outside a big hospital that provides a lot of services and I want to protest against other issues within that hospital, I'm not sure that that's the point of this bill, to try to stop that from happening. Is there any mitigations or ways that we could prevent those protests from, in your opinion, being part or part of this bill? You would have to get some freedom to the Procreate of Fiscal to take a reason decision. You can't make an absolute offence, then anything's going to be caught in it. One of the examples when we were talking about this before I came today, in theory, if you're talking about a busy entrance to the hospital, a mother pushing a newborn baby in to receive prenatal care could be viewed as influencing somebody who's going from the abortion, because she sees that newborn baby, but the tour entirely unrelated and nothing to do. So you have to give some prosecutorial discretion to think, actually, that's not what this is for and I'm not going to prosecute that. Provided you allow that element of discretion, there shouldn't be a problem. Other than that, protests presumably can be agreed in advance and can be agreed to be in a particular area and not, hopefully not for the tour overlapping. Okay. Would it be possible for you to write to us with perhaps some ways of wording that? Thank you. Just to pick up on that, in the previous panel we had Colin Pullman from RCN, and so if there was like a labour dispute, as we've seen, and if I was approaching the hospital to receive a service, but I did see placards folk standing in scrubs or whatever. That we need to make sure that some language in the bill allows the unions to make a protest about wages or terms and conditions or whatever, but that is how would we make sure that if I was approaching from a distance, I don't assume it's an anti-abortion protest? I don't know how you can do that. I mean, I think there's already the provision in the Act about the Trade Union Act for Peace of Picketing, so you could no doubt expand on that for other protests. I mean, I think you're moving away from legal terms to reality. I think there is no way in reality you can control what somebody who's going to access hospital thinks when they see a group of people three or four hundred yards away that they don't know what they're doing. That's just life, but if somebody who's accessing these services is aware that when they're accessing services, there will be no when they're specifically trying to target them, then that must to some extent ease their mind. Right, so that would provide assurance, bringing forward this legislation. It would provide assurance for people accessing healthcare services that they will not encounter a protest influencing them accessing the service. You can't stop somebody thinking, I don't know if that's a protest or a group of people waiting for a bus because there's five hundred yards away, but all you can do is make it easier so that you can never eliminate the problems. Is there any other issues in relation to the bill that haven't been covered in questioning by members that you wish to express a view on? I had a question about one of the exceptions, I think, is in section 6. I'm not sure if I understood what it was getting at. I think it was that you're an exception if you were another person working within the premises, the protected premises. I wasn't sure what thinking was behind that, because it struck me that that could mean, and I hope it wouldn't happen, that, say, in a hospital, a cardiology team could protest within the hospital, and they would be an exception. However, I may be completely misunderstanding that clause. We'll certainly note that point in trying to establish more detail around that potential intersection. Is there any other points that witnesses would like to raise? I'd just like to touch on the financial provisions of the bill and what financial impacts the bill could have. Just to ask the witnesses, do you feel that the anticipated financial impact of the bill is proportionate to its purpose? Does anyone have a particular view on that, Mr Brown? I don't have a particular view. I would imagine that you're not going to be talking about a huge amount of prostitution, given the level of protest that we've seen at present. I would have thought that the tens would be likely, rather than anything of an above that. Just for the record, from a local authority perspective, there are no financial implications for us in it. We would have a small implication in training and bringing people up to speed, but it's relatively straightforward, so I see it as minimal. Thank you for that point of clarification. On that, unless there are any other further points from any of our members, I'm happy to rest on that. Thank you very much for witnesses' attendance today. I really appreciate your contribution to the committee's work. We'll move on to the next item of business, which is subordinate legislation. We have four negative instruments in front of the committee today. The first instrument is the national health service, optical charges and payments and general ophthalmic services, Scotland amendment regulations 2024. The purpose of the instrument is to increase by an overall of 1.68 per cent the values of NHS optical vouchers accepted or used by a supplier in Scotland on and after 1 April 2024. It also brings into effect various administrative changes relating to the provision of general ophthalmic services, otherwise known as GOS, on and after 1 April 2024. The policy note states that the NHS optical vouchers provide financial help towards the purchase of new glasses or contact lenses for eligible persons, including children aged under 16, those aged 16 to 18 and qualifying full-time education, those on a low income and those who require complex lenses. Some people are also eligible for an NHS optical voucher for help with the cost of repairing or replacing glasses or contact lenses. The Delegative Powers and Law Reform Committee considered the instrument at its meeting on 27 February and made no recommendations in relation to this instrument. No motion to annul has been received in relation to this instrument. I ask if any members have comments to make in relation to this statutory instrument. Therefore, I propose that the committee does not make any recommendations in relation to this negative instrument. Does any member disagree? I see no disagreement. I can confirm that. The second instrument is the national health service common staffing method Scotland regulations 2024. The purpose of the instrument is to specify the minimum frequency at which the common staffing method is to be used in relation to specific types of healthcare and the staffing level and professional judgment tools that must be used as part of the common staffing method for specified kinds of healthcare provision. The policy note states that the instrument is required to specify that the common staffing method must be used no less than once annually in relation to certain types of healthcare. The regulations also specify the specialty-specific staffing levels tools and the professional judgment tool that should be used as part of the common staffing method for specified kinds of healthcare provision. 10 specialty-specific staffing level tools are named in the instrument alongside the particular kind of healthcare provision for which each tool is to be used. The Delegative Powers and Law Reform Committee considered the instrument at its meeting on 27 February this year and made no recommendations in relation to this instrument. No motion to annul has been received in relation to this instrument. Members will, however, note that the Royal College of Nursing has written to the committee raising certain specific concerns in relation to the drafting of the instrument. The letter for the Royal College of Nursing raises a number of wider issues that the committee may wish to consider as part of its future post-legislative scrutiny of the Health and Care Staffing Scotland Act 2019. In relation to the correspondence that we have received, I therefore propose that we write to the Scottish Government requesting that they address the specific points raised by the Royal College of Nursing and to consider that instrument at a future meeting. Do members agree with the proposed action? The third instrument that we are considering this morning is the personal injuries NHS charges amount to Scotland amendment regulations 2024. The purpose of the instrument is to amend the personal injuries NHS charges amount to Scotland regulations of 2006. The instrument will increase the charges, otherwise known as NHS charges, recovered from persons who pay compensation, compensators in cases where an injured person receives national health service hospital treatment or ambulance services. The increase in charges relates to an uplift for hospital and community health service, HCHS annual inflation. The policy note states that the instrument will allow for new NHS charges to apply in cases where compensation has been made in respect to incidents occurring on or after 1 April 2024 with NHS charges being revised annually to take account of the hospital and community health services pay and price inflation. The scheme is administered on behalf of the Scottish ministers by the compensation recovery unit of the Department of Work Impensions in accordance with an agency arrangement under section 93 of the 1998 Scotland act. The Delegated Powers on Law Reform Committee considered the instrument at its meeting on 27 February this year and made no recommendations in relation to this instrument. No motion to it and all that has been received in relation to this instrument. Do any members have a comment to make in relation to the statutory instrument? No. Therefore, I propose that the committee does not make any recommendations in relation to this negative instrument. Does any member disagree? That is okay. We then move on to the fourth and final instrument, which is the social care and social work improvement cancellation of registration and relevant requirements order of 2024. The purpose of the instrument is to ensure that the care inspectorate can propose to cancel the registration of a care service under section 64 brackets 1 of the Public Services Reform Scotland Act 2010, otherwise known as the 2010 act, or report a certain local authority provided care services to the Scottish ministers under section 91 brackets 3 brackets bravo of the 2010 act following a breach of section 7 and or 8 of the Health and Care Staffing Scotland 2019 act. The 2019 act comes into force on 1 April 2024. The policy note states that the instrument specifies new grounds on which the care inspectorate may propose to cancel the registration of a care service, namely that the service is being or has at any time been carried on other than in accordance with section 7 and or section 8 of the 2019 act. It also specifies the requirements imposed by sections 7 and 8 of the 2019 act as relevant requirements for the purposes of section 91 brackets 5 brackets charlie of the 2010 act. The Delegated Powers and Law Reform Committee considered the instrument at its meeting on 27 February this year and made no recommendations in relation to this instrument. No motion to annul has been received in relation to this instrument. Do any members have any comments to make in relation to this instrument? No. Therefore, I propose that the committee does not make any recommendations in relation to this negative instrument. Does any member disagree? No. Okay. I have confirmed the agreement. At our next meeting on 12 March, we will continue taking evidence as part of the committee's stage 1 scrutiny of the abortion services safe access on Scotland Bill. That concludes the public part of our meeting today. Thank you.