 Fyelidog, iawn. Mae'r ysgol sydd ymddangos gyffredinol syniadol yn gyfodol gyda unrhyw fawr, darllen, ddynis Robertson. Rwyf i ddydig i'r ddweud o'r SPCB, yn oes o'r bwysig o'r cyffredinol yn gymhwyllwgol yn ddwyllol garden lobby exhibition area to improve the visibility for greater photograph opportunities. I say to Mr Robertson that I understand the difficulty that he is talking about in relation to better photo opportunities. However, consideration was given back in 2012 to installing additional lighting in that space, but there are technical challenges and this has resulted in a significant cost so we didn't pursue that option. As an alternative, we use specialised lighting attached to the display boards and that illuminates the various different exhibitions in the area. This lighting is not designed to add light to the general area and the corporate body has no plans to install additional lighting there. I thank Linda Fabiani for that response and I can fully understand if there is a significant cost and technical problems. Does the Parliament provide the additional lighting for the exhibition boards and could any additional lighting be added? When people come and they are displaying the events and exhibitions, one of the things that they want to do is ensure that they, as an organisation, can get good-quality photographs out to their social media. I can see that issue and we do install additional lighting for the boards, etc. There are technical challenges associated with doing any permanent lighting and, as I said, the cost is prohibitive. However, I am sure that the staff of the Parliament and the relevant staff are always willing to look at how things can be enhanced. I hope that, following the subject being raised in the chamber, we can look again not at installation of permanent lighting but at other options that could perhaps be used to give a better experience for those who use that space. To ask the Scottish Parliamentary Corporate Body how it disposes of food that is left over from events and functions. To start off with, the events and catering teams work very closely with the event organisers to try and provide guidance on the food choices and, most importantly, the amount of food that is required. Any food that is left over is put into the food waste bins, and that is collected by our waste disposal contractor and taken away for composting. Obviously, that helps to reduce the amount of waste that we send to incineration. According to Greener Scotland, every year, 380,000 tonnes of food and drink are thrown away, which does not have to be. That costs the Scottish public over £1 billion every year. The Parliament has the objective to be a zero-waste Parliament, throwing out food does not seem to be in line with that ideal. Could it be possible for the corporate body to discuss with caterers and others to look at the possibility of where it is possible that food that is left over from functions and events is passed on to the various food kitchens in Edinburgh, which supply food to essential homelessness individuals and others who demand to be fed? Can I say first of all to the member that those discussions go on all the time because the Parliament very seriously takes its responsibilities to try and reduce waste of all kinds and food waste all the time? That is why we have detailed discussions with those who are organising the events. That is why we are also looking at installing a food waste monitoring tool so that we can understand a bit better how and where food is being wasted so that we can have better discussion, more informed discussion and take appropriate measures. Can I say, though, that there are issues around what on the surface of it seems a very worthy way of doing things, as suggested by the member? One has to remember that when one is catering for events, the food is unpackaged, it is being prepared, served, it is not temperature controlled and you have to be very careful that you do not allow something to become a risk for human consumption and sometimes it has to be classed as waste. Having said that, discussions are always on-going about how best to manage those things and I am absolutely sure that the good management of the SPCB staff in this institution will carry on that discussion along with the corporate body that is elected after the election in me. Many of us would like to increase the amount of food for disposal and I refer in particular to the coffee in committee rooms. On behalf of my colleague on the Audit and Education Committee, Colin Beattie, and colleagues across this Parliament from all parties, can I ask if the corporate body will ensure that new and existing and continuing MSPs get a decent cup of coffee in committee in session 5? I guess that it is all a matter of taste. I quite like the coffee that we get in committees. In fact, I think that we are very lucky getting coffee in committees. I mean, it is hard times now, it is an aesthetic. To Mary Scanlon, I have heard this over the past couple of years and I know that the Parliament staff have had coffee tastings for members to try and choose what they thought was the best coffee. I do not know what else we can do to be perfectly honest to Mrs Scanlon. I would suggest that the fact that very often the coffee irons are empty would suggest that most people are quite happy with the coffee that is offered. I am trying to think on my feet of a solution here. You can get very good coffee bags and we could probably supply some really hot water. I share Mary Scanlon's concerns with the coffee. A compliment is on her efforts to improve the quality of the coffee. One thing that I have observed that may help the corporate body is that on odd occasions I have been in committees that I have met very early in the day and on those occasions the coffee seems to taste much better. I suggest that part of the problem at least may be the fact that at times coffee is left standing in those vacuum flasks for quite a long time and that impinges on the quality of its flavour. If the corporate body is going to direct its activities in such a way as to improve the quality of the coffee, perhaps it could look at minimising the amount of time the coffee is in those vacuum flasks. I am going to pass the buck here. Perhaps the next corporate body could look at this, but could I suggest that people get a bit more healthy and drink more water? I am sure that Linda Fabiani is not expecting this one either. On the same topic of food waste, I am just wondering whether the SPCB has considered and they probably have, but in the mornings when breakfast is over what is left is gone into waste immediately. Would they not consider using the bacon, the sausages etc into rolls? I love cold bacon rolls. I think that there are folk in this establishment that have paid to be looking at such options and I am sure that they are listening avidly to this session to see if there is anything that they can do to improve the experience of MSPs and we will get back to you on that one Mr Robinson. That concludes this item of business and we now move to the next item of business, which is stage 3 proceedings on the health, tobacco, nicotine etc. and Care Scotland bill. In dealing with the amendments, members should have the bill as amended at stage 2, the marshal list and the groupings. The division bell will sound and proceedings will be suspended for five minutes for the first division of the afternoon. The period of voting for the first division will be 30 seconds and thereafter I will allow a voting period of one minute for the first division after a debate. Members who wish to speak in the debate on any group of amendments should press the request-as-seat buttons as soon as possible after I call the group and members should now refer to the marshal list of amendments, which we will now turn to and will address group 1 and I call amendment 1, in the name of the minister, in a group on its own minister, to move and speak to amendment 1, please. Thank you, Presiding Officer. This is a technical amendment required as a result of an amendment to the bill at stage 2. The stage 2 amendment added to the relevant enforcement actions, which can count towards an application for a tobacco and NVP banning order. The purpose of the amendment is to make clear that this is not a requirement that at least one offence has to have been committed under chapters 1 and 2 of the 2010 act before a sheriff could be satisfied that a banning order can be issued. That ensures that a banning order can be applied for where the three relevant enforcement actions pertain to convictions under section 921b or c of the Trade Marks Act 1994. I move amendment 1. Many thanks. The question is that amendment 1 be agreed to. Are we all agreed? We are. Many thanks. I will now move to group 2 and call amendment 3, in the name of Malcolm Chisholm, group with amendment 4, minister Chisholm, to move amendment 3 and speak to both amendments in the group, please. Thank you, Presiding Officer. The two amendments relate to the section of the bill that deals with the duty of Cander. As most members will know, that arises if a person experiences unintended harm. In that situation, the organisation involved will have a duty to tell the person, to support them, to review the situation, to learn lessons and to apologise. I am a strong supporter of the duty of Cander, but when I, with some of my colleagues on the health and sport committee, visited our Gowan hospice back in September as part of our palliative caring inquiry, we also asked them about this bill and in particular the duty of Cander section of it. The consultant in palliative care and I think some other staff at the hospice did raise a concern then that there may be some people who do not wish to be informed about the experience that has caused unintended harm. They were obviously thinking of a hospice situation, but there may be other situations when the person does not want to know or it could even be the relative, of course, if the person in question is no longer alive. That was a question that was also raised in our stage 1 deliberations. Peter Walsh of Action Against Medical Accidents was one of the people giving evidence and he has had a great deal of experience of how the duty of Cander has operated in England. It is already in law there and he is a great supporter of the duty of Cander, but I did find what he said about one of the provisions in English legislation quite interesting and I'll just read his quotation briefly. He says, the way that has been dealt with in England is that there is a requirement to tell the patient or service user or their family that there is something to report and to discuss and they can simply say thanks but I don't want to know and he goes on, let us say that mum or dad has passed away, the family can say we're moving on and we don't want to know another thing and he says that is their absolute right but it is not the right of any individual health professional or organisation to decide for them that they do not need the opportunity to know and that last bit is very important because we're trying to get beyond the paternalistic culture that we used to have in the health service so we may think or whoever the appropriate health professional may think oh well it's not really in the interests of this person to know this or the interests of the relative of this deceased person to know this but that is not the way to deal with this because people have the right to know and they must therefore be asked if they wish to know so my amendments are an attempt to deal with this I introduced amendments at the committee stage and I've now done it in what I think is a simpler form and also take account of one of the concerns raised by the minister in response to my amendments at committee now I'll a great deal of them what is going to govern the duty of candor procedures is in regulations and the critical section of the bill is clause 22 and I have added bits or proposed adding bits to two of those sections section three it says section 22 subsection two and again subsection c of that refers to the meeting with the relevant person and what I've proposed at the end that that in the regulations governing that they should include asking the relevant question whether the relevant person whether the relevant person wishes to receive an account of the incident but one of the points that the minister made in committee was of course even when the person or the relative of the person expresses a wish not to know it's still critically important that there is a review of the circumstances that have led to the harm and therefore I've proposed another amendment in this case to subsection i which relates to reviewing the circumstances and I've proposed there that even if the relevant person has advised that the relevant person does not wish to receive an account of the incident the review still has to go ahead so that lessons can be learned so I accept that a lot of this is going to be in regulations but there is a general question always when we pass legislation to what extent are we just going to take on trust what's going to be in the regulations or to what extent should we flag up in primary legislation what must be in the regulations and I think my amendment strike the right balance here I accept we can't work out all the details of this in this bill today but I think we should have the right to flag up certain really important dimensions of the regulation so I'll listen obviously with interest to what the minister says about this but in the meantime I move amendment 3. Thank you very much to support Malcolm Trism's amendments. My experience in health service I'm well aware that there are patients who certainly don't want to know the detail of what goes on even in their own treatment whether there have been mistakes or not but I appreciate that for the duty of candor it is necessary for them to know there has been something but I think it should be absolutely within their right not to have to hear the detail of what the concern is and I think Malcolm Trism's amendments actually support what I think on this issue. Thank you. Many thanks and I call on Rhoda Grant. Very briefly again, Presiding Officer, at stage 2 I argued that the duty of candor should go through all health and social care processes and that patients should be informed of their treatment and given most all the information that was available and that was to make that treatment person centered and I think that Malcolm Trism's amendments just emphasise that the person must be in control of the information they receive and whether or not they want detail so it is about the person being at the very centre of that treatment so they can refuse to have information or they can indeed have all the information about their care. Minister. Thank you Presiding Officer, like the other speakers I recognise that it may not always be in the best interest of the individual to be told about what has happened and in implementing the duty of candor organisations will be required to consider this carefully and ensure that they don't have a one size fits all approach to disclosing information. Organisations will be required to check whether or not the affected person wants to be told about what went wrong but regardless the main aim is that organisations will be required to take steps to review incidents whether or not the affected person wants to be told about what went wrong. The bill allowed this to be included in regulations and the Scottish Government's duty of candor implementation advisory group will of course include this in taking forward the bill's implementation. Presiding Officer, given Malcolm Trism's persistence on this point in the bill and perhaps as a parting gift from the Scottish Government, I'm content to support amendments 3 and 4. Malcolm Trism, to wind up and press a withdrawal his amendment. Well I thank the minister very much for that but I can assure her I'm not parting yet. I've got two and a half weeks worth of speeches left. Thanks. And so the question is that amendment 3 be agreed to, are we all agreed? We are. Thank you very much. Call amendment 4 in the name of Malcolm Trism already debated with amendment 3, Mr Trism, to move or not? Move. Thank you very much. And so the question is that amendment 4 be agreed to, are we all agreed? Many thanks. We now move to group 3 and I call amendment 2 in the name of the minister and a group on its own. Minister Maureen Watt to move and speak to amendment 2 please. Presiding Officer, I indicated at stage 2 that an amendment would be brought forward at stage 3 in relation to the care worker offence of ill treatment or willful neglect. That is set out in section 26 of the bill. This amendment adds that offence to the list of offences in the Police Scotland 1997 act, which must always be disclosed on higher level disclosures. I thank Mary Scanlon for the work that she did on this particular amendment. The serious nature of this offence and the breach of trust involved is such that the passage of time will not diminish the relevance of this information to a prospective employer or organisation. This amendment ensures that Disclosure Scotland will always disclose spent convictions for this offence. The inclusion of this offence on the offences, which must always be disclosed list, means that no matter how old the conviction is, it will always be disclosed on a higher level disclosure and therefore is available to employers and voluntary organisations. I thank the minister for her response and I also thank her for the very reasonable hearing that I felt that I got at stage 2. I am grateful that she has brought forward the amendment today. This was born out of, like most of us, a constituent Mrs Blan Bremner, whose mother, Mrs Doreen McIntyre, died in a care home in Inverness. She gave me permission to use her name and she has asked me what I could do in this Parliament to stop people who abuse and neglect and maltreat elderly people in care homes from simply walking out and getting another job. I am very grateful to Maureen Watt, the minister, for bringing forward this amendment. Given that I am not on the committee and I am not steeped in the understanding of the bill, I wonder if I may just ask for some clarity. At stage 2, the minister said that, more specifically in relation to the offences in part 3 of the bill, a court may, when convicting an individual, refer that individual to Disclosure Scotland if it thinks that that might be appropriate for the individual to be considered for listing. That was the minister's response at stage 2. I heard what she said today, but this just slightly bothers me because it seems to bring a degree of uncertainty saying that the court may, when convicting the individual, refer to Disclosure Scotland only if they think that it is appropriate to be considered for listing. I know that, on behalf of Mrs Blan Bremner, she certainly would not like anyone to suffer in the way that her mother did, and it is just to make sure that this is quite watertight. In relation to Mary Scanlon's point, I will make sure that what she says is clarified in the regulations and guidelines on the implementation of the bill. Many thanks. The question is that amendment 2 be agreed to, are we all agreed? We are. Thank you very much. That ends consideration of amendments. We now move rapidly to the next item of business, which is a debate on motion 15801 in the name of Maureen Watt on the health, tobacco and nicotine, et cetera, and care, Scotland Bill. I invite members who wish to speak in the debate to press their request to speak with them now or as soon as possible, and I call on the minister Maureen Watt to speak to and move the motion. Minister, you have a generous 10 minutes. Thank you very much, Presiding Officer, and I'm delighted to open the debate today on the health, tobacco, nicotine, et cetera, and care, Scotland Bill. I'd like to thank the finance committee, the delegated powers and law reform committee and particularly the health and sport committee for their consideration and scrutiny of the bill as it has progressed through the parliamentary process. The bill is a wide-ranging bill and, if passed, will contribute towards helping people live longer, healthier lives, tackling significant inequalities in Scottish society, and improving the delivery of health and social care services in Scotland. Cross-party support in this Parliament to prevent the harm caused by tobacco use has seen Scotland remain a world leader on tobacco control. This Government has been clear that it will continue to encourage everyone, but particularly children and young people, to choose not to smoke. By so doing, we hope to create a tobacco-free generation of Scots by 2034, creating an offence of smoking and of knowingly permitting smoking in a perimeter around buildings on NHS hospital grounds is an important step in continuing to denormalise smoking behaviour and achieving our ambitious target. As I've said before, it's not about stigmatising smokers. Preventing ill health is a major challenge for our health services now and in the future. Tobacco remains the biggest cause of preventable disease and death in Scotland. I'm proud that the NHS has and will continue to show leadership in supporting and promoting healthy behaviours, particularly around tackling smoking. The bill brings forward control specific to e-cigarettes for the first time in Scotland, or nicotine vapour products, NVPs, as they are termed in the bill. There has been much debate about the potential risk and the potential benefits of those products among experts. Such interesting and lively debate has also been evident during this Parliament's consideration of the bill, but I'm pleased that we've not allowed that debate to become sensational. The Scottish Government has worked closely with experts and stakeholders and listened to their views in order to achieve the right balance in regulating NVPs. I'm pleased that we can all agree that non-medicinal NVPs should not be available to children under the age of 18 and that over-18s should be prevented from purchasing them on their behalf. Such agreement has also been widespread for the benefits associated with placing further age controls on the sale and purchase of tobacco products. The requirement for persons intending to sell NVPs to register on the register of tobacco and NVP retailers has been the focus of much of the debate on part 1 of the bill. That is because of concerns raised that the requirement to have a single register will send a message that NVPs are just as harmful as tobacco products. However, there has been agreement that a single register is required in order to reduce the burden on retailers and enforcement officers. As I indicated in my response to the health and sport committee, this issue is about how the register is presented. I've already committed to providing a separation between the products on the website where the register is held. This does not require a change to the legislation and will be managed during implementation. There's nothing in this bill that demonises NVPs or NVP users. I've been clear that any public health gains should not be hindered by unnecessary regulation. However, there has been agreement that there is no place for marketing of the products to children, young people and non-smokers. The detail of such prohibition will be set out in regulations. The bill also places a duty of candour on health and social care organisations. Increasingly, it is recognised that openness and transparency are essential elements of health and social care systems. The duty of candour will apply to those organisations that provide healthcare, social care and social work services, and it will help to promote an open learning culture and accountability for safer systems. It will be a driver for staff engagement and improvement work, and it will engender greater trust among patients and service users. The bill requires that when an organisation becomes aware that there has been an adverse event resulting in harm, the duty of candour procedure must be followed. The procedure that will be set out in regulations will require organisations to take action to meet with and apologise to the affected person and provide support to them. The procedure will detail the requirements for the recording and monitoring of incidents and the provision of training and support for those carrying out the duty of candour procedure. The bill requires all organisations to report publicly on the number and nature of the events that have been disclosed to people and confirm that the obligations of the organisational duty of candour have been met. It is worth remembering that legislation only forms one part of the duty of candour. We will work with stakeholders to produce guidance and national training resources to assist organisations in the implementation of the duty of candour. Many organisations already have procedures in place for handling complaints or responding to adverse or significant events, and therefore the additional administrative demands of the duty of candour should be minimal for most. Care, compassion and dignity are central to the vast majority of health and social care that is delivered every day right across Scotland. The provisions in the bill on ill treatment or willful neglect strengthen corporate accountability in health and social care and allow the criminal justice system to hold individuals and organisations to account where they are responsible for serious and deliberate neglect or ill treatment in the course of providing care. Those offences are not about catching people who are doing the best they can in a busy environment. They are about dealing with those situations where someone intentionally sets out to neglect or ill treat another in their care. Where neglect or abuse has taken place, it is important that there is access to justice for those victims of such neglect or abuse. The bill will help to achieve that. Provision of communication equipment and the associated support required to use that equipment are key requirements of children and adults who have lost their voice or have difficulty speaking. The provisions in the bill place an explicit duty on Scottish ministers to provide or secure the provision of communication equipment and associated support. In addition, under the existing powers of the 1978 act, Scottish ministers will issue directions to health boards in the near future to help support the discharge of this duty. Those directions will be developed in consultation with a group of stakeholders and will contain the correct level of detail to address the operational issues that we know are a cause for concern. The group will meet next week to start the development process. Loss of voice has a huge impact on individuals affected and the bill will ensure that those in need have access to the appropriate equipment. Importantly, they will also have access to the support that they require to enable them to lead as independent a life as possible and to participate in society. I move motion S4M-15801, in my name, that the Parliament agrees that the Health, Tobacco, Nicotine, etc. and Care Scotland bill be passed. I thank the committee staff, the legislation team and all the others who helped with the process of the bill and all those who came to committee and gave evidence in person and those who submitted evidence in writing, helping us to scrutinise the legislation. The bill is a bit cobble together. It is a piece of legislation that covers many different areas and sometimes appears to confuse issues and appears to link them together as being part of the same thing, but sometimes that has been unhelpful. Controlling nicotine vapour products and legislation to stop smoking outside hospitals makes a link between the two issues. That sometimes became an issue that caused confusion. As was introducing a duty of candour in the same place as criminalising willful neglect, again at times confused drawing links that simply were not there. If I can turn to NVPs nicotine vapour products, it is fair to say that we are a long way from having the last word on NVPs. Evidence is sketchy with a new product and therefore legislation will change as more becomes known about them. What is clear however is that evidence strongly suggests that they are much safer than cigarettes and could save lives as an alternative to smoking and therefore any negative suggestions within the bill that discourage people from moving from cigarettes to NVPs would not be helpful. That said, we cannot say that NVPs are safe either. There is little legislation covering the chemicals that are included in the various brands that do not all have the same chemicals in them and therefore it is difficult to assess any harm and indeed legislate for it. Neither is it clear what the health effects of some of those chemicals are, some of nicotine, but that is not always the case. While we would encourage smokers to move to NVPs, it would be foolhardy to suggest that non-smokers should take up vaping as well. The legislation, as it looks at smoking in hospital grounds, tended to get confused with NVPs, but it did not include NVPs at all. Much of the part of the bill dealing with smoking in hospital grounds will be delivered through regulations and that will require to be scrutinised. It is difficult sometimes to imagine how the legislation will work in practice, given the different locations that will be covered by the regulations. What was clear in the committee was that windows and doorways should be always clear of smoking, but how you then maybe deliver that if they are looking out on a street is something different. There were concerns about staff having to enforce the legislation or if they did not find themselves at odds with the law. There were also concerns that staff might also commit an offence if there were assistant patients to get outside if they wanted to smoke. The minister assured us that that was not the case, that the only staff that would be involved in enforcing the legislation would be those that were employed specifically for that purpose. Therefore, there is no conflict between policing the legislation and the needs of a patient and, indeed, the duty of patient care. The bill, as we have spoken about in amendments, introduces a duty of candor for health, social care and social work organisations. That means that if a patient or a client is accidentally harmed by treatment, they need to be told. However, the bill only legislates for this in cases where the harm is significant and there is a reporting procedure as well as a procedure for an apology to be given. I still maintain that there should be a duty of candor running through all actions and errors so that we have open and transparent services and people should be informed of all aspects of their treatment as well as when mistakes are made. That would build confidence in the service and lead to a patient-centred approach. While it would be time-consuming and impossible to surround all of that ethos and duty of candor with a bureaucracy, it should be part of what is recognised as the information that patients are due to have and should have at all times unless, as Markham Chisholm suggested in his amendment, they do not wish to have that information. The part of the bill that talks about willful neglect was sometimes confused with the duty of candor because they seem to be on the same spectrum. That is absolutely not the case. The duty of candor is about informing patients about unintended consequences and genuine mistakes. Willful neglect is just that, it is willful, it is neglect and mistreatment and it is intentional either through direct malice towards a patient or client or because the owner or manager does not provide adequate resources to ensure that there is a reasonable quality of care in an establishment. Where a carer cannot provide an acceptable level of care because they have not been given the time or resources, they are not liable, but their employer is. However, if they neglect or mistreat a service user, they will be personal way to responsible. Most people in the caring professions are compassionate and provide selfless care, and I think that we would all pay tribute to them. However, there is a minority who choose to enter the profession but who do not really care about the treatment of vulnerable people. It is only right that they should feel the full force of the law, and I am pleased that anyone who is convicted under the law will have that conviction remain so that they can never be in the position that they can do that again. At stage 2, the Government put forward an amendment that added the provision of communication equipment to the bill. I think that that was certainly welcomed by everybody in the committee and beyond. The amendment is down to the work and dedication of Gordon Eakman, who has campaigned tirelessly for this and indeed for better services across the board for people with disabilities. He is an amazing man who has achieved a lot in such a short space of time. We can only imagine what losing the ability to speak is. It will be devastating, and therefore, communication equipment is a lifeline to allow people to express their wishes and to continue to be part of their social network. How frustrating it must be to be able to listen surrounded by people but not be able to contribute. When that discussion is about your own life and your circumstances and care, it must be even worse. A right to communication equipment is therefore necessary, and our welcome addition to the bill. In conclusion, I would like to say that we will be supporting the bill tonight, because we believe that it will make a real difference to the lives of our constituents. This afternoon sees the completion of the fifth piece of legislation scrutinised by the Health and Sport Committee in the past few months of this Parliament. I would like to echo the thanks that it has already expressed to all those who have contributed to our understanding of the bill's provision and worked to make improvements to it as it has made its way through the parliamentary process. I feel particularly indebted to the committee clerks who have shouldered a heavy workload recently and to the witnesses who provided written and oral evidence to us as we scrutinised the bill in its early stages. The Health, Tobacco, Nicotine, etc. and Care Scotland bill contain three important pieces of legislation. Part 1, as we know, progresses the Scottish Government's anti-smoking strategy by including policies around tobacco, nicotine and smoking. Part 2 introduces a duty of candour to encourage a culture of openness within the NHS and social care services. Part 3 brings in a new offence of willful neglect and ill treatment aimed at health and social care professionals and providers of care. In preparing for this short debate, I found the briefings from Ash Scotland and the Royal College of Nursing very useful, as they neatly sum up the general response to the provisions of the bill as it comes to the end of its parliamentary scrutiny. Part 1, dealing with the regulation of electronic cigarettes and a statutory ban on smoking within a designated distance from hospital buildings, is widely accepted and welcomed. Ash Scotland focuses on NVPs as a means of reducing the use of tobacco, which is the goal of everyone involved in public health. There is a growing body of anecdotal evidence that e-cigarettes have assisted previously very heavy smokers to quit smoking when all other attempts have failed. Passed any potential harm from the use of NVPs will have to be monitored over time. There seems little doubt that they are very much safer than tobacco products. There are, however, concerns about people who are using NVPs alongside tobacco, and particularly about attempts to recruit non-smokers into nicotine use via NVPs. That is why the bill's proposals for age restrictions for a ban on self-service sales through vending machines and a requirement for the registration of people selling e-cigarettes and for them to adopt age verification policies are seen as sensible and proportionate. The proposed restrictions on marketing and particularly on promotions aimed at young people will, I think, be useful in preventing vaping from becoming a gateway to smoking, which appears to be happening in some countries, although not yet in the UK, I believe. The ban on smoking in designated parts of hospital grounds will give statutory backing to the current position of most NHS boards that have introduced smoke-free policies in hospital grounds and is receiving a general welcome. Although I have had concerns expressed to me about patients in psychiatric hospitals who find it extremely difficult to give up smoking, I do, however, agree with the health board's assertions that the physical health of people with a mental health problem is as important for them as it is for other members of society. In that context, I find Ash Scott's suggestion of testing the success of weaning such patients on to e-cigarettes to help them to quit tobacco altogether is an interesting proposal and one that could also be tested in the prison population where heavy smoking is also the norm. I fully accept that MVPs are much safer than tobacco-based products, but there is as yet no knowledge of any potential harmful effects of vaping in the future. I think that the evolving use of MVPs needs to be monitored over time, and to that effect I would hope that a future Parliament might find time to look at the effectiveness of the proposed legislation on public health in a few years' time. With regard to other parts of the bill, some concerns have been expressed about the need to introduce a duty of candor, but I think that there is a general acceptance of it as a driver for cultural change within health and social care services. However, the RCN still has serious reservations about parts 3 of the bill, which introduces the offence of ill-treatment and willful neglect, because it feels that it might work against building the cultural transparency that we all want to see within our health and social care services if people feel that they could be under the threat of litigation, particularly when they are faced with the stresses of a shortage in workforce capacity. The duty to provide or procure communication aids and support for those who need them is, of course, a very welcome addition to the bill, which I am more than happy to endorse, because, as the minister has said, communication is essential for human wellbeing, and the inability to communicate can be quite devastating for people who are so affected. I remember a friend of mine who had a stroke following which he could understand what people were saying, but he could not articulate back. It was very, very obvious that that was the most frustrating thing that he ever had to cope with in his life, and he was like that until his dying day, so I do feel very strongly about that particular matter. I will go into a little more detail about the reservations that were expressed about parts 2 and 3 of the bill in my closing remarks, but, overall, I find that its provisions acceptable, and Scottish Conservatives will be supporting the bill at decision times afternoon. We now move to the open debate, and I call on Willie Coffey to be followed by Malcolm Chisholm. The bill marks another stage in post, I think, in the long journey to improve public health in Scotland and our aim of limiting exposure to smoking and to discourage smoking behaviours. If the bill is approved, it will also help to improve patient safety and the rights of patients by introducing this duty of candor, or openness for care providers that was debated and agreed earlier. It will help to regulate the sale of NVPs or e-cigarettes, and it aims to reduce the possible exposure that youngsters are currently getting to these products and making ill treatment and welfare neglect in social care settings a criminal offence. The overall aim is tobacco no more by 2034, a tobacco-free generation in Scotland with the consequent benefits for public health and savings for the public purse. Our key prizes to be won if we are successful, but it will not be easy. We are dealing with addiction and substantial vested interests, and frankly many people actually like cigarettes and do not intend giving them up, but it is interventions like this that we make to stop people taking up the habit that will probably get us to that tobacco-free Scotland eventually. It is estimated that it costs the NHS in Scotland about £400 million every year, treating smoking-related illnesses with about 33,500 admissions, and sadly about 13,500 deaths each year attributable directly to smoking. If you look at the scale of the problem we have, cigarette sales in the UK are worth about £13 billion a year, and a nice check of about £10 billion of that goes to the Treasury and duty in VAT. Sales of e-cigarettes in the UK were estimated about £127 million a year. Last year, nearly £33 billion of cigarettes were released into the market in the UK, and you can estimate that of that about £3 billion or so of those were smoked by people in Scotland. Thankfully, the trend is coming down. In 1999, over 30 per cent of adults over 16 smoked in Scotland, and now it is down to about 23 per cent of their abouts. That has to give us all some encouragement. The bill itself splits into the three parts that some members have said already. The first prohibits the sale of e-cigarettes or NVPs to anybody under 18, and it will be an offence to purchase those for someone under 18. It will prohibit their sale from vending machines, and retailers will have to register that they sell them as they do for ordinary tobacco products. The second part of the bill deals with care settings and places this duty of candor and health and social care organisations to inform people that they have been harmed as a result of care or treatment received. I welcome the amendment that was accepted by the minister earlier, as outlined by Malcolm Chisholm. Thirdly, the bill creates a criminal offence of ill treatment or willful neglect in health and social care settings. A brief word on the e-cigarettes issue. I know constituents of mine and some colleagues in here who say that they have helped them to reduce their smoking habit, and the Scottish Government recognises that they may have a role to play in quitting smoking. However, there is limited data available to allow us to be conclusive one way or the other, but I am pretty sure that that will emerge in due course. The bill is another good step forward for us in helping to prevent younger people from getting hooked in smoking and helping to protect people in healthcare settings, as has been outlined. I think that we are winning the battle in smoking, but there is still a long way to go until we can finally extinguish cigarettes from Scottish culture once and for all. 2034 seems a long way off from now, but, if we get that right, we can look forward to that tobacco-free society in Scotland. Thank you very much. I would observe that this is the fifth bill that the health committee has done in recent times in the last five months to be precise, as I know because I have only been on the health committee for the last five months. Unlike her, I want to pay tribute to our clerks who have been brilliant on the bill and, in fact, all of our very heavy workload. I would like to thank the people who drafted our amendments and, of course, the people who gave such useful and important evidence to us at stage 1 of the bill. There are five elements in the bill now. The first two, I can deal with them quite quickly because everyone supports the right to voice equipment when it is required, and I welcome the fact that that has been brought forward. In fact, the specific smoking provision in creating a legal basis for no smoking in hospitals has actually proved at the end of the day not to be controversial, although there was a lot of discussion about it at stage 1. Obviously, some of the detail of that will come in regulations, but I think that everybody welcomes the fact that that policy is going to be strengthened by being given a legal basis. The duty of Canada that I have already touched on in my amendment is to describe, as others have done, what the purpose of it is. I thank the minister again for accepting my two amendments on that. Again, reflecting on the evidence that we received, Mary Curie, Unison and others supported the legislation strongly because they thought that it would help to drive culture change and help to ensure an organisational shift towards a supportive culture of learning and improvement. That is certainly the intention of that, and I think that it is up to everyone to make sure that that intention is realised in practice. I think that one of the recommendations of the committee in its stage 1 report was that it needs to be co-ordinated, planned and resource programme of awareness-raising, training and support for the staff responsible for implementing the policy. That is clearly crucial. Moving on to the ill treatment and willful neglect offence. Again, the crucial distinction here, which was perhaps not always clear in some of the concerns expressed to us, is that that is to do with deliberate actions, unlike the duty of candidates. Again, the issue of training, support and education for relevant staff and organisations is absolutely crucial, so that people understand what the offence is and make sure that people know, in particular organisations, what their roles and responsibilities are. Perhaps the most contentious at the end of the day turned out to be the provisions around nicotine vapour products, although I do not think that today we will replicate the sometimes acrimonious tone of the debate that we had at stage 1, when people, as it were, pro e-cigarettes lined up against each other. I think that the striking thing is that although there are widely varying views in the Parliament and outside about this, all of us support what is in the bill. I proposed an amendment at committee just to make sure that we can distinguish between the e-cigarette part of the register and the tobacco part of the minister, Rhea Shorby, when I had a meeting with her that she will appear quite separately to the public on the website. I think that that meets, at least in part, the concerns of many people who do not wish ordinary cigarettes and e-cigarettes to be completed in any of the possible context. We all support, obviously, actions against young people accessing these products and we all support a degree of advertising control, although, again, the detail of that will come out in regulations. There were many pieces of useful evidence and I was particularly struck by the evidence of Professor Linda Bald, who is in a great deal of work on e-cigarettes. You may have heard her on Good Morning Scotland at 7.15 this morning and, certainly, I have been very influenced by her views on that. One of the things that she said in evidence to us was that a recent study shows that people in the UK who stopped smoking using e-cigarettes are 60 per cent more likely to be successful than those who use well-power alone or who buy nicotine replacement therapy over the counter. We all want to see Scotland reaching its ambitious target of reducing smoke and prevalence to 5 per cent by 2034. I am sure that we would like to see it even lower, but I do believe that e-cigarettes have a role to play in that. While supporting the provisions in the bill, I hope that we will be spared the rather negative comments about them that we sometimes hear. As I mentioned back in December during the bill's stage 1 debate, Scottish Liberal Democrats of course welcome plans to help people to live healthier lives with better guidance and better support through better, bolder health initiatives. I was also glad to see the response of the Scottish Government at the stage 1 committee report ahead of the debate and the commitment set out for increased spending on health research. I will return to some of the points that I made then for the importance of basing our decision in this bill and the regulation of NVP products on substantial and robust evidence while, of course, more research is being carried out on the effect of NVPs on health. There are also more issues around NVPs that I think we still have to consider, as many others have said today. Issues such as the marketing and messaging of NVPs, making sure that it is provided as an alternative to those who want to quit smoking and not to be used to entice non-smokers to start. I am encouraged by the commitment that is given by the Government, also in its response to the stage 1 report that NHS Scotland and the Scottish directors of public health are revisiting their positions on reflecting new evidence, and that consistency is marked as a priority among NHS stopping smoking services. I will remind the members that the passage of my own members' bill in December aims to protect children's health, and I would not like to see counterproductive measures to that in subjecting them to new ways of inhaling nicotine and other harmful substances. I hope to see the measures in the bill being taken forward, of course, productively. Another issue that I voiced concern about was the balance between the use and necessity of the duty of candor and the new responsibilities that are placed on health and social care organisations. The imposition of the legal requirement must be accompanied, I believe, by the right education and support for our hard-working NHS staff. The Royal College of Nursing states that it is crucial that staff have the required knowledge and skills, and that they receive adequate training and support around the duty of candor. I welcome the fact, however, that that will apply to organisations and not individuals, as that can help to manage the risk better in my view, and will lead to more effective learning practices. The views of some of the professional organisations, such as the BMA, must also be considered and taken into account, as ever, of course. Deputy Presiding Officer, no practitioner wants to see their patient's heart or harm or receive a level of care of less than they deserve. However, those instances happen where there is ill treatment and willful neglect, so it should be the duty of the health and social care actors to recognise their responsibility and, of course, to be held to account. I was recently contacted by a constituent who was misdiagnosed with a minor infection rather than cancer, which was the case. Despite repeated visits to the hospital, that constituent was dismissed, had insufficient checks of their medical history and has caused cancer to develop into one that is now an incurable one. The person is now trying to buy as much time to spend with their family because of this mis-treatment. I believe that going a step further and putting in place the right protections, not only for staff but also for patients, increases the humanity of our health service and recognises the fact that people need to be treated holistically, not just in some medical silo. We are very supportive of the bill today and look forward to voting for it at decision time. Thank you very much. I will now turn to the closing speeches and to Colin Nannette-Mill. I will begin my closing remarks on this debate by returning to parts 2 and 3 of the bill. I grew up in a paternalistic NHS where patients expected and received very little information about the treatment that they were given and who accepted without question that health professionals, particularly doctors, knew best and did their best even when things went wrong. Never would they ever have thought that such people might apologise for any mistakes made even if they were admitted. Thankfully, we live in a very different world today where information is widely available. I think that it is only right that patients are as involved as they wish to be in their treatment plans and progress and that, when something happens, which has been or could have been harmful to them, they have the right to know about it. Of course, not everyone wants to know the detail of the event that went wrong, and that is also their right, but they or their carers and families should be made aware that there is information available to them. A culture of openness where health and care organisations and staff within them feel able to admit mistakes and learn from them. To inform service users or their carers and families when some treatment has resulted in some harm to them can only lead to an improvement in patient safety, and that is paramount in a well-run health and social care system. For that to happen, staff must be supported so that they can learn from mistakes and make improvements so that such errors are less likely to occur in the future and that they will require proper training in the knowledge and skills that they will need to comply with a duty of candor in a more open climate within the service that implies them. I think that, in the past, there has sometimes been a tendency within health and care organisations to cover up mistakes and that it should be possible in this day and age to be open about them and to apologise to service users when they happen. Of course, a duty of candor does already exist for many health and care professionals, but it does not cover all professions and there can be resulting inconsistencies in the application of such a duty in health and care organisations, which, hopefully, this bill will eliminate and allow those organisations to follow best practice and learn from incidents of unintended harm with resultant improvement in the care that they provide so that such harm does not arise again in the future. The new offence of ill treatment and willful neglect is intended to apply only to the most exceptional cases of neglect to real treatment, and we know that sadly there are such cases which have been exposed, but even when proved, the perpetrators have, on occasion, been able to find other employment within the care sector. This was highlighted by my colleague Mary Scanlon in an example that she gave at stage 2, and the Minister's stage 3 amendment to deal with this was very welcome indeed. The RCN, however, still has serious reservations about the introduction of this new offence, and they genuinely feel that it could have the opposite effect of what is intended by introducing a duty of candor with the threat of criminal proceedings mitigating against the building of a culture of openness and transparency. So, Presiding Officer, given the comments and concerns that we have heard about parts 2 and 3 of the bill, it seems clear that the education, training and support of health and care professionals will be crucially important in developing the desired culture of openness in our caring professions and organisations. I hope that all aspects of this legislation will have the outcomes that they seek to deliver, but I think that it will be very important to scrutinise them in a few years' time, so that the accumulating evidence on the uses of NVPs, the practical application of the duty of candor and the use of the new offence of willful neglect and ill treatment can be revisited and assessed for their effectiveness. I think that we all accept the need for post-legislative scrutiny of the statutory provisions that we make in this Parliament. Where there are evolving situations or reservations expressed by respected bodies like the RCN, it is particularly important that those are reviewed in the future, and I hope that that will be undertaken by future members of the Parliament. However, as I said in my opening remarks, overall, we are content with this bill as amended, and we will give it our support. Many thanks. I should have said at the start of closing speeches that we have a few minutes in hand if members are inclined to take interventions or wish to take a little bit longer in their speeches. I call on Rhoda Grant. Six minutes or so, please. Thank you, Presiding Officer. I think that this has been a good debate, and it is sometimes difficult to debate a bill that covers such a range of different issues. I suppose to sum it up. We all want and look forward to a tobacco-free society, as Willie Goffy said, and this bill will go some way towards it. However, we also look forward to a society where there is better patient-centred care. Again, I think that the bill will help with that. The minister mentioned the single register for NVPs and tobacco products. That was one of the things that really got the committee thinking, because there were certainly concerns from people like pharmacists who were concerned about having to register as tobacco retailers if they were going to use NVPs as part of their smoking cessation programme. It was very clear that we had to make sure that there were no barriers for NVPs being used to help people to stop smoking. However, at the same time, we had to make sure that the protections were in place. Malcolm Chisholm, as he said, put forward amendments and sought that. I think that he received that reassurance from the minister that there would be dealt with quite separately to give comfort to organisations that would be selling NVPs, certainly for therapeutic reasons. We have to be careful about the use of NVPs, because, while there are undoubted health benefits as an alternative to smoking, they may have health problems themselves. We heard about something called popcorn lung, which we did not go into. However, some of the chemicals that are used in NVPs can cause other conditions that might have health problems all of their own. Therefore, I think that it was right and proper to put in restrictions about age to whom they could be sold and restrictions on vending machines. A lot of speakers talked about wanting to use NVPs as an alternative to smoking. However, Jimmy Hume certainly made the point that they should not be used as an axis into nicotine dependence. We had some evidence from the committee that said that some of the other chemicals that are used in cigarettes actually make them more addictive, so that nicotine-used in NVPs might not be as addictive as nicotine in cigarettes. However, again, it is a developing industry and those things can change. Therefore, we would certainly never want to see those kinds of chemicals used in NVPs that would make people more addicted to them, especially if there are health problems. Nynet Milne talked about smoking in hospital grounds, certainly for psychiatric patients. There were real concerns there, because if someone is not well, obviously chemicals have an impact on that. We need to make sure that people in psychiatric hospitals have the ability to smoke if they really need to. Mary Scanlon and I visited New Craigs and were delighted to see that there was going to be secure outside space at that hospital to allow people to go outside. That would be really important in all psychiatric hospitals, where people might not be so able to give up smoking when they were receiving treatment. We need to be sure and be clear about giving people those choices, especially when they are suffering from conditions where it would be cruel and unfair to make them change behaviour when they need our compassion. The member raises a very interesting point. It shows the need for a person-centred approach and some leeway. Increasingly, the evidence is coming forward that in terms of mental health patients and prisoners, if they were given the encouragement to give up smoking, it would actually help their overall health and that those options should be available as well. I was not suggesting for one moment that those options should not be available because addictions of any kind have an impact on people's mental health. Stopping smoking is obviously the desired outcome. It is just how we get people to do that if they are not well. We need to have compassion alongside encouragement to stop smoking. There was a lot of discussion about the duty of candor. I will re-emphasise that that is a really important part of patient care. Patients should have the information that they need when they are receiving care. However, the duty of candor in the bill can be quite bureaucratic in that there is a reporting system and a system for an apology. I hope that, when guidance is given about how to implement the bill, the apology is meaningful. If the process were mishandled, it could actually cause additional distress. People need to be quite clear that the apology has not just been given because it has to be given, but it has to be given and meant. Malcolm Chisholm pointed out that the part of the bill is not so much about punishing, but it is about keeping patients informed, but it is also about learning and improving the service that we give to people. His amendments, even when a patient does not want to exercise their duty of candor, allowed for the circumstances surrounding the event to be examined, so that staff could learn from that experience. That is really important and echoed by Nanette Milne, who talked about the paternalistic NHS. I hope that we have seen the back-off. I think that bits of it still exist here and there, but I think that it is really important that we make sure that it is patient-centred, not staff-centred and not led. Nanette also raised the issue of the RCN's concerns about willful neglect, and her concerns that it would be a barrier to openness and whistleblowing. Rightly she wants that reviewed, and I think that I echoed that, because it is really important that we have a very open health service and that there are no barriers to people reporting concerns and making sure that they do not happen again, but saying that while supporting very much the offence of willful neglect, because Mary Scanlon talked about a case, we have all had cases that have been really sad and heartbreaking about willful neglect of patients. When that is in a palliative care setting, that is even worse, because there is no way of pulling back that and making something better. It can lead to families having real difficulty getting over their grief. Just touching on communication equipment, I am not sure how much time I have. I can allow you time to touch on the equipment, the communication equipment. Thank you very much. I raised with the First Minister at question time the Sue Ryder report about neurological disorders and the treatment of patients. I think that this communication equipment is a step towards that, because it is a lot of people that have neurological disorders that also have changes to their communication. I think that it is important that this should be one part of that. We have to go back and look at how we provide care for neurological disorders, examine that closer and come forward with a strategy in the next Parliament to make sure that people, especially young people, or people who have lost us in the net mill and talked about our friend, who had lost the ability to speak, get the care and treatment that they want. On that note, I will simply reiterate that we will support the bill tonight. Many thanks and I now call on Maureen Watt to wind up the debate. Minister, you have until 15.50. Thank you very much, Presiding Officer. I would like to thank members for their contributions this afternoon. I welcome the breadth of support that the bill has received through all its parliamentary stages and the constructive nature of what members have said in the debate. In particular, I would like to offer my thanks to those experts who gave their time to provide evidence to the health and sport committee, almost all of whom advocated that this legislation was both proportionate and necessary. I think that the bill offers us a real chance to progressing our commitment to ensuring that people in Scotland live longer, healthier lives. I would also like to thank the bill team for all their hard work in getting us to this point today. It is, Presiding Officer, an important milestone. It will play its part alongside the vast range of measures that will continue to be progressed by the Scottish Government to reduce tobacco-related harm. It will also see specific regulations of NBPs put on the statute book for the first time. Many members in the debate mentioned how NBPs are a new product and evidence on their effectiveness or whether they are harmful is still emerging because they are such new products. Of course, we absolutely do not want to stigmatise people who are using NBPs to come off tobacco-related products, which we know are much more harmful. It is really quite amazing that we can start to put in place legislation on a new product and not be playing catch-up like we have been with tobacco products and alcohol products. That is why we are committed to preventing access to NBPs by young people under the age of 18. However, alongside that, we want to consider what more could and should be done to control the sale and marketing of these new products. That is why we will make sure that there is no advertising of these products on billboards and posters. We now see advertising of these products on television and there is EU legislation that must come into domestic UK law by 2016, making sure that these products are no longer advertised on the media. I am confident that the bill has struck the right balance in that respect. In doing so, we contribute to children having the best start in life by creating a society where they are supported to make healthy choices. The bill will help to build further openness and transparency in our healthcare systems. It allows patients and service users to know about what has gone wrong in the course of their treatment, should they wish. It will encourage apology and a learning and improvement to prevent it from happening again. The idea that Nanette Mill raised and that the RCN raised in its briefing that the offences will prevent a culture of transparency implies a kind of pessimistic view of the attitudes of health and social care workers. I do not share that view as the offences are not aimed at instances of unintended or unexpected harm. I am sure that, as the law comes into force, any reservations will be dispelled. Part 3 is about premeditated neglect or ill treatment. Rhoda Grant was right to point out that duty of candor and willful neglect are completely separate. Premeditated neglect or ill treatment of people receiving healthcare or social care is deplorable. Those who commit such crimes, including organisations and individuals, need to be dealt with by the criminal justice system. The bill will provide specific action against those crimes. It has been born out of incidences, thankfully not in Scotland but in other parts of the UK. It is important that people know that, in the very small number of cases where there has been willful neglect, that people can expect a respectful and compassionate care rather than have, and where there has been willful neglect that people are suitably punished. The net mill and others mentioned mental health patients and prisoners and their use of tobacco. It is up to health boards to implement strategies as part of their wider commitment to health improvement. Now that prisoner health is under health boards that should make it easier in terms of prisoners stopping smoking. Improvement in patient safety and the health of individuals goes right through the bill. I know that Rhoda Grant said that it was all-encompassing and a lot of different things we have had catch all bills before, but it is important that the bill is passed at decision time. The addition to the bill of the voice augmentation communication equipment is to be welcomed by everyone. This morning, I visited the Ewan MacDonald centre and met Ewan and Young Greta and Paul, who are in the gallery, and saw how the use of voice equipment enabled them to join in conversations with others. The equipment is so wide-ranging now, and that is why the clauses in the bill have been left deliberately open so that people can have access to the right equipment at the right time. Rhoda Grant mentioned the Sue Rider event last night. I have a devue court in my constituency, and I visit it often. I can see how, for many patients, voice equipment given at the right time would be very useful. In approving the wide-ranging bill, the Parliament will be contributing to a number of better outcomes for Scotland, including continuing to build on our vision of a tobacco-free generation by 2034, protecting non-smokers, but particularly children and young people from nicotine addiction by reducing access to and marketing of these new products, improving the delivery of health and social care services, and ensuring that nobody in Scotland dies without a voice. I thank all members who have helped with the passage of the bill. There have not been many amendments at stage 2 or, indeed, today at stage 3. I cannot guarantee that that will be the same for the burials and cremations bill, which the Health and Sport Committee has also to consider at stages 2 and 3, but I hope that Parliament will unanimously pass the bill at decision time. That concludes the debate on the health and tobacco nicotine etc. Can I just say to members that there is a likelihood that we will be sitting beyond 5.30 next Tuesday, so that it will of course be subject to the parliamentary bureau on Tuesday morning, but I thought that you would appreciate our heads up in that matter. I am minded now to accept a motion without notice from Joe Fitzpatrick on behalf of the parliamentary bureau, bringing forward decision time to now. Happy to move, Presiding Officer. I will now put the question. The question is that decision time be brought forward to now. Are we all agreed? We now move to decision time. There is one question to be put as a result of today's business. The question is that motion number 15801, in the name of Maureen Watt, on the health, tobacco, nicotine etc. and care Scotland bill, be agreed to. Are we all agreed? The motion is there for agreed to and the health, tobacco, nicotine etc. and care Scotland bill is passed. That concludes decision time and I now close this meeting.