Official Report 737KB pdf
Property Factors (PE2006)
Our second item is consideration of continued petitions. The first of those is PE2006, which was lodged by Ewan Miller and calls on the Scottish Parliament to urge the Scottish Government to amend the Property Factors (Scotland) Act 2011 to cover dismissal of property factors or to lay other regulations that would achieve the same aim. That could include giving the First-tier Tribunal for Scotland housing and property chamber powers to resolve disputes related to the dismissal of property factors.
We last considered the petition on 13 November 2024. At that point, given all the different bits of evidence that we had received, we felt that, in order to understand matters better, including the position of the Scottish Government, we would invite the Minister for Victims and Community Safety to give evidence. I am absolutely delighted that the minister, Siobhian Brown, is with us this morning, together with a number of Government officials. Rather than my doing so, I wonder whether the minister would like to introduce the officials to us and tell us what they do.
I would like them to do it.
In that case, I invite each of you to introduce yourselves and explain your work, because four different voices will sound much more interesting than my just reading it all out.
I am a solicitor at the Scottish Government legal directorate.
I am part of the housing registers team, which is part of the better homes department, where I deal with policy and customer focus issues.
I am in the private law unit, dealing with property law, among other things.
I am from the private law unit, dealing with property law.
When I invited you to do that, I did not realise that it would sound like “University Challenge”. I should now say that that was your starter for 10. [Laughter.] Thank you all very much, and welcome.
If you are content, we will move straight to questions. I invite you to decide, minister, when you would like members of your team to contribute—that will be the easiest way forward.
As a general opening comment, I note that the committee has not fully understood why the Scottish Government thinks that no new legislation is required to deal with the problem that has been raised in the petition, given everything that we have heard from the petitioner about the difficulties of navigating the current arrangements.
If I could, convener, I would like to start with a few opening remarks to provide a bit of clarity, as there is a bit of crossover between my portfolio and that of the Minister for Housing on the issue.
Thanks very much, everybody, for the opportunity to talk about the dismissal and the appointment of property factors, and to provide an update on the progress of the voluntary code of practice for the dismissal and the replacement of land-owning land maintenance companies.
My property law portfolio responsibility covers the dismissal and the appointment of property factors—sometimes referred to as switching—which includes the land-owning land maintenance companies. The Minister for Housing has portfolio responsibilities for the Property Factors (Scotland) Act 2011, which includes the register of properties factors and the code of conduct. My comments will focus specifically on my portfolio.
I know that the petitioner has called for legislation to cover the dismissal of property factors. Legislation is already in place that deals with that matter. If the title deeds of a property do not set out how the property factors are to be dismissed, provisions under the Title Conditions (Scotland) Act 2003 and the Tenements (Scotland) Act 2004 will apply.
As I have indicated in my previous responses to the committee, I consider that the existing remedies by which home owners might dismiss a factor are adequate and that a legislative change at this time is not necessary. I note that, in its response to the petition, Under One Roof said that the process to dismiss a property factor is not clear—I will come on to that—while the Property Managers Association Scotland considered that the current legislation on the matter is sufficient.
I recognise, however, that some home owners find the procedure to switch property factors complicated. A guidance note on manager burdens will be published shortly on the Scottish Government website, which will help home owners to navigate the various options with regard to establishing voting procedures.
I have spoken to my officials this morning and the website says that the guidance will be published shortly. I am told that the timescale is within the next few weeks, but there are a few technical issues with the graphics that are being added to the website.
To be clear, what will that do?
It is guidance on the various options for how voting procedures should be carried out when dealing with factors.
I understand that, but the petitioner’s argument is that those who seek to dismiss property factors in the civil courts find that the whole process is not practical. Because of the intimidatory nature of potential legal costs and the unquantifiable nature of what they might be, it effectively flashes the frighteners, if I can put it that way, at residents who might feel that that is what they want to do so they hesitate before doing so. How do you respond to that inherent fear, which they say is a deterrent to acting on that instinct, even when they feel that it is what they have to do?
I appreciate the petitioner’s comments and his experience, but it is quite rare that this has happened with factors. However, we need to ensure that a process is in place for anybody who wants to remove a factor. Usually, that is in the title deeds, so it would be unusual if that was not in place.
Moving forward, if someone feels intimidated because they have to get legal advice or go through the court process, I think that they should feel supported through our guidance. My officials might want to come in with something further here.
No matter which body you take such cases to, there will be a legal nature to it. Those cases are complicated, and they are not things that everybody deals with every day. It might just be that, because they are complicated, people will need legal advice, whether that is from the sheriff court or from another judicial body such as the First-tier Tribunal, and everything comes at a cost.
I appreciate exactly what you have said, however. It can be intimidating. The tribunal is supposed to be less intimidating, but there are complaints that people lawyer up and that is just the nature of the beast. It is complicated, and people on both sides of an argument need to have the right legal advice.
Thank you. Is it Mr Leeton?
Leetion.
Will the advice that is being worked on be a pamphlet or an online directional guide? How would people know that that advice is available and find a route to access it?
I will pass over to Jill Clark, who has been involved in the design of it.
It will be online. I imagine that we will also get in touch with consumer groups and bodies such as Under One Roof to make sure that everybody is aware that it is available. We are trying to make it very simple to follow, with a flow chart, so it is clear what a home owner has to do and that they need a certain amount of votes in order to act. It will cover what applies—is it your title deeds or is it other legislation? It should be accessible, and it will be promoted.
Am I correct to say that, in support of the Government’s view that separate legislation is not needed, the initiative is designed to illustrate how individuals would navigate the current process, which the Government believes ought to be satisfactory to meet the issue of dismissal?
Yes, that is correct.
Finally, the minister and Jill Clark have touched on Under One Roof in its contributions. In its submission, the organisation takes the view that the complexity of the law on dismissing property factors, as well as the separate issue of what some people see as the intimidatory nature of the costs that they might be contemplating, is a barrier to home owners who want to switch property factors. It all looks too difficult to navigate. Is there a hope that the advice will also assist with that issue? Is that your response to the views of Under One Roof?
09:45
That is part of it. As I said in my opening remarks, there has been a delay in issuing the voluntary code of practice because of pressures on the team. We are looking at doing that within the next six months. The draft has gone to key stakeholders to try to simplify the process. That will be in addition to what will be online on the Scottish Government’s website.
Does anyone else have any views on how the voluntary code of practice will help?
The voluntary code of practice relates to landowning and land maintenance companies, so it will certainly help in that area. The guidance that we should be putting out shortly should help people to navigate the existing system when voting on property factors.
That scene setting was interesting. Do colleagues have any questions?
I suppose that I should declare that I am still on the roll of solicitors and am registered with the Law Society of Scotland, although that is more of an expense than an interest, albeit a merited expense.
The thesis of Mr Miller’s petition is that he is calling for the legislation to be amended to enable the dismissal of property factors or for other regulations to be laid that would achieve the same aim. It seems to me that two things should be said about that. First, I think that Mr Miller is concerned not about tenement properties but about housing estates with open land that requires maintenance. The difficult issue of green belt has been a running theme with which I grappled—unsuccessfully, I should confess—during my time in your shoes, minister.
Secondly, it seems to me that the nub of Mr Miller’s concern is not so much the issue of who is the factor but of how much they charge. In her evidence to the committee on 13 November 2024, Sarah Boyack cited an example in which the charges had increased dramatically, with quarterly fees rising from £300 to £800 pounds.
If I am right that the nub—the beef—of the issue is not so much who the factor is but what they are doing and whether they are fleecing the owners, the owners’ problem is that going through the ordinary cause procedure in the sheriff court is too expensive. I know that they are absolutely right about that and can say beyond peradventure that only the very rich or those who are on legal aid can litigate in ordinary cause courts and that the cost deters everyone else.
I understand, minister, that you are providing the orthodox answer—as perhaps I did; not always but too often—that there is a remedy. The orthodox answer is that people can go to court and that is fine, but they cannot go to court because they do not have the money to go to court, so that is a theoretical remedy and not a practical one.
I will suggest a possible solution, although I do not know whether it will fly. We have, as alternatives to the ordinary cause court, the small claims court and the summary cause court. The small claims court is intended as one to which parties can go to explain their case, first in writing and then in person to the sheriff, with no lawyers involved—at least, lawyers should not be involved, although companies often send King’s counsel. That is absurd, but that is what they do. Expenses are not usually awarded by that court unless there is an abuse of process. I am not talking about the summary cause court but about the small claims court, because summary cause is similar to ordinary procedure and practice, in which lawyers end up being involved.
There could be a stipulation regarding charges that are shown to be excessive in accordance with simple evidence given by a tradesman about the ordinary rates for that trade. A change from £300 to £800 per quarter is an absurd increase by any account. The example that Sarah Boyack cites is an increase of almost 300 per cent and we have no reason to doubt that that is correct.
Would the answer not be to confer privative jurisdiction on the small claims court and give the sheriff in that court the power under legislation, if, in his discretion, he finds that the factor has overcharged and abused the system and a claim has been completely excessive, to say, “Look, you’ve abused your power. You’re no longer the factor”? That could be set out quite simply in law as a matter of principle. I checked “Gloag on Contract” and I think that the claim would be dealt on a quantum meruit basis. I have no doubt that Jill Clark and Megan Stefaniak can correct me if I am mistaken on the law.
I do not expect the minister to be able to answer that, because I have not given her notice of my question—I thought of it only last night when I was looking at the committee papers. I wanted to set out my suggestion and I am grateful to the convener for allowing me to do so at some length.
Thank you, Mr Ewing. You intervention was interesting. It might be a little unreasonable to expect the minister to have an immediate response to that. I do not know whether you want to respond, minister? If you want to give it some further thought, would it be helpful for us to make available the Official Report with Mr Ewing’s suggestion at the earliest opportunity?
I would like to give it some further thought, but we are always open to new suggestions as to how we can simplify the process. I am probably putting my colleagues on the spot, but I do not know whether they have any initial thoughts about the legal implications of Mr Ewing’s suggestion, or whether it is simply a case of our going away and thinking about it.
We will have to consider it and come back to the committee.
We have touched on the nub of the issue, which is people’s terror about the unquantifiable cost that they would incur.
To round off some of the discussion, what is the minister’s assessment of how the legislation allows access to justice?
Legal aid is available for people who apply and are eligible for it. There should be no problem with anyone accessing justice if they would like to.
Just to be clear, is it the Scottish Government’s position that the current approach allows for a justice system that is up to date, fair and respects the rights and diverse needs of users?
Yes, that is my understanding. Do my officials want to say anything other than that?
If home owners have any issues with property factors relating to the requirements of the Property Factors (Scotland) Act 2011, they can take that to the First-tier Tribunal. There is no cost to take a case to the tribunal, although the legal advice has costs. Separately, a home owner can take a matter to the sheriff court if it specifically relates to title deeds or the dismissal of a property factor.
What is the Scottish Government’s view on the Competition and Market Authority’s report and its position that the current system of private management of housing estates might lead to consumer detriment?
The Scottish Government welcomes the CMA’s report and is grateful for its engagement with officials and the Scottish market in its investigation. It is a substantial report. Ministers and officials are considering the recommendations and will respond fully in due course. The suite of recommendations extends over a few ministerial portfolios and the impact of each recommendation needs to be considered in the wider context.
I understand that the Minister for Housing considers that it would be useful, while examining the findings and the recommendations of the CMA, to add more voices to the discussion, and he might include them in the proposed round-table session with property factors. It is under consideration.
I am sure that we all appreciate that we are running down the clock in this parliamentary session. Is there any more detail on how and when that response might be published?
That has not been made clear to me, but, as I said, the Minister for Housing is looking into it. We can perhaps write to the committee on that.
Good morning, minister. In a previous submission to the committee, the Scottish Government stated that it had received fewer complaints about property factors over the past 10 years. Is the minister aware of how many property factors have been dismissed in the past 10 years?
I am not aware of that number; I do not know whether any of my officials have it. We might have to write back to the committee with those details.
Do you think that the present system is fair and democratic?
Yes, I think that it is. However, we do not have the exact number of how many dismissals there have been in the past 10 years; it has not been specifically on my radar in my ministerial role for the past two years per se. However, if there are ways in which we can improve the system, the Scottish Government is always willing to look at them.
I suppose that leads to Under One Roof’s view that the Government should seek the views of housing professionals, owners and other organisations on what options might exist for reducing the barriers for owners to replace property factors. Have you given consideration to amplifying, perhaps, the options that others, such as Mr Fergus Ewing, might have for what could be done? Arguably, the number of factors that have been dismissed will be suppressed if people are deterred by the process from bringing forward an action to try to deter the property factor in the first place. Those barriers might limit that number.
Yes, absolutely. One of the things that I can do, which I take away from this evidence session, is to speak with the Minister for Housing, because if he is going to have a round-table session to examine the recommendations from the CMA report, that consideration could be intertwined with that.
That is very helpful. Thank you.
It seems that colleagues do not have any further questions. It was quite brief this morning, minister, but I think that, from our point of view, we got to the nub of the matter. It was short but sweet—I am sure that you are perfectly happy that that was the case. We thank you all very much for your participation.
09:57 Meeting suspended.Surgical Mesh and Fixation Devices (PE1865)
Welcome back. We continue our consideration of continued petitions.
PE1865, which was lodged by Roseanna Clarkin and Lauren McDougall, calls on the Scottish Parliament to urge the Scottish Government to suspend the use of all surgical mesh and fixation devices while a review of all surgical procedures that use polyester, polypropylene or titanium is carried out and guidelines for the surgical use of mesh are established.
We are joined for our consideration of the petition by Katy Clark and our former committee colleague, Carol Mochan, both of whom have previously been concerned with the issues raised by the petition. Good morning to you both.
We most recently considered the petition nearly a year ago, last March, when we agreed to write to the Cabinet Secretary for NHS Recovery, Health and Social Care and to the Scottish Parliamentary Corporate Body. At this point, I should probably remind colleagues that I am a member of the SPCB.
The SPCB’s response sets out the process for appointing the patient safety commissioner for Scotland. The post was first advertised in March 2024, although, as members might be aware, it remains unfilled and was readvertised on 7 February.
We have also received a response from the Minister for Public Health and Women’s Health, which highlights the expectation that, regardless of where mesh removal surgery takes place, local health boards should provide any necessary aftercare that patients might require. The response also highlights that
“A patient should decide upon their treatment with their clinician, following meaningful discussion and sharing of all necessary information”,
and that those discussions should be documented.
On the issue of natural tissue repair, the minister tells us not only that a “significant number” of hernias are repaired without mesh in Scotland, but that Government officials are working with surgeons who have a specific interest in hernia repair and have begun to identify individuals who have the skills to take forward surgical hernia repair that is consistent with the Shouldice technique, on which the committee took oral evidence from the Shouldice folk in Canada back in February 2022—PE1865 is a long-standing petition.
We have also received two submissions from the petitioners. The first draws our attention to an article in the Journal of Abdominal Wall Surgery on hernia repair surgery in adolescents and suggests that a similar approach, whereby consideration is given to the risks of hernia recurrence and mesh complications, should be adopted for hernia repair in adults. The petitioners believe that hernia surgery should be considered as principled surgery, with surgeons being trained specifically in the Shouldice and natural tissue repair techniques as well as mesh techniques. In their second submission, Roseanna and Lauren restate the call for a centre of excellence to be established as a means of ensuring that informed patient pathways are available for natural tissue repair and mesh removal.
Alongside that call, the petitioners continue to advocate for an independent review of the use of mesh, and they have provided a brief summary of their meeting with Terry O’Kelly, who is the Scottish Government’s senior medical adviser, whom the committee previously heard from, and representatives of the Scottish Health Technologies Group, which has only strengthened their calls for an independent review to be carried out.
I will invite Katy Clark and Carol Mochan to contribute before the committee considers how best to proceed. However, it is only fair to say—I say this as someone who has been closely associated with the issue for more than a decade—that the committee is not certain how to take this particular petition forward. Important issues have been raised. There has certainly been some advance in respect of the Government’s approach to the use of Shouldice techniques, which was a bit of an uphill push, but which the committee, with our introduction of the Shouldice evidence, helped to make happen. However, we are a little unsure as to what more we can usefully do, given that the parliamentary session is now beginning to wind down from the point of view of our ability to consider petitions.
I am keen to hear from Katy and Carol before we make any determination. It has been decided that Katy will speak first.
I am grateful to have the opportunity to make a contribution. I have met some of the petitioners on a number of occasions, including this week. The lead petitioners are both constituents. One of them has suffered quite severe complications as a result of the hernia mesh procedure; the other is the daughter of a deceased person who was also a constituent and who underwent the hernia mesh procedure. They are working with a range of campaigners across Scotland—and, indeed, the rest of the United Kingdom—who are collating information about the complications.
The submission that I made to the committee very much focuses on data. As the convener said, we had the opportunity to meet the minister and, as a result of that, we had a subsequent meeting with medical advisers and officials. It is clear to the petitioners that there is a lack of data in relation to the extent of the problem.
I have previously advised the committee of freedom of information requests that were submitted to health boards. We did not get information from many health boards, but the information that we got was concerning. The petitioners are concerned about the basis on which work is proceeding. Frankly, the data that we have does not truly reflect the scale of the number of people who have complications. That was the focus of the written representation that I made to the committee.
I wonder whether the committee would be willing to engage further with the Scottish Government on the issue, as it is clearly not an issue that will go away. The petitioners and many others continue to suffer the consequences of the hernia mesh procedure, and the campaign will continue. It would be appropriate for the Scottish Parliament to be engaged with that in order to ensure that an evidence-based approach is taken and that work is undertaken to gather such evidence.
Has the subsequent meeting that you mentioned taken place? Am I correct in picking up that it has?
Yes, that is correct. That meeting took place before Christmas. I attended it, along with the petitioners.
Okay—thank you.
I thank the committee for inviting me to attend the meeting, because, as members know, I have previously spoken on the issue, and I want to ensure that people are fully aware of the extent of the situation involving people who have undergone the mesh procedure.
I echo the points that have been made by Katy Clark and the petitioners in their submissions to the committee. I support their point about the lack of data on the number of patients who are experiencing complications as a result of the use of mesh. It is concerning that we do not know whether we are capturing that data, which is important. The submissions highlighted the fact that the data that is currently being relied on is inconsistent, incomplete and often outdated. We should all take that issue very seriously. I will not repeat the point that the convener made about that, which was well made. It is clear the minister has taken the issue seriously.
Although the Scottish Health Technologies Group report is interesting, there is good reason to think that the data sets that it used are, as one of the petitioner’s submissions highlights, “narrow and incomplete”. Action could be taken to look at that.
In addition, the absence of follow-up data is worrying. We do not know whether any follow-up work is being done, although a commitment has been made that such work will be done. The full extent of mesh-related complications is also worrying. Given that complications might not be immediately apparent after surgery, could we have a system in place that would allow us to look at that?
I echo the points that Katy Clark made, and I request that the committee keeps the petition open and perhaps writes to the Government regarding a review of the current data sets, so that we can continue to support the work of the petitioners.
Thank you. Do colleagues have any thoughts? I am between a rock and a hard place on this one. There is probably not much more that we can do in this parliamentary session, and I am minded to move to close the petition. However, I might be prepared to defer closing it, and to indicate to the Government that although we are moving in that direction, we would like to have further confirmation on the points that have been raised about data, in particular.
If colleagues are content, we could approach the Government to get a specific response on that. However, we should be mindful of the fact that, notwithstanding any response that we got, we are probably nearing the point at which we would have to say that any future work on the issue would be best served by the lodging of a fresh petition in the next session of Parliament. I think that I would feel most comfortable if we agreed to go down the route of giving the Government a further nudge on the aspect that arose from the work of the Scottish Health Technologies Group, as amplified in Katy Clark’s written submission and the oral submissions of our colleagues.
The evidence that we have heard from our colleagues today indicates that there has been a lack of response from health boards. I do not know why that is, but that is the situation. Because that is the case, Katy Clark sought to obtain relevant information but has not received it. Were we to close the petition today, the petitioners could easily and legitimately lodge a fresh petition, calling for the data to be analysed. Rather than have all that delay and extra work, we might as well keep the petition open so that we can ask for the information that Katy Clark has, quite rightly, sought. I am aware of the evidence that Clare Adamson gave on behalf of her constituents. Plainly, those who are affected have been affected very profoundly.
Do we agree to keep the petition open on that basis?
Members indicated agreement.
Universal Free School Meals (PE1926)
PE1926, which was lodged by Alison Dowling, calls on the Scottish Parliament to urge the Scottish Government to expand universal free school meals provision for all nursery, primary and secondary school pupils.
We last considered the petition at our meeting on 17 April 2024, when we agreed to write to ask the Cabinet Secretary for Education and Skills for an update on the phased roll-out of free school meals provision in primary schools and to confirm the Scottish Government’s position on a pilot for universal free school meals in secondary schools.
In her response in May, the cabinet secretary stated that the roll-out of free school meals to primary 6 and 7 pupils who are in receipt of the Scottish child payment remained her priority. She also provided information about the funding that was given to local authorities to support the expansion of the free school meals programme, which is expected to come into effect this month.
Although the cabinet secretary’s priority is building towards the universal provision of free school meals for primary pupils, she went on to say in her response that the Scottish Government was considering initial views from local authorities on a pilot for secondary schools. Members will be aware that, since we received that response, Parliament debated the provision of free school meals for primary school pupils, in September 2024. Although the motion was non-binding, the Parliament agreed that free school lunches should be provided for all primary school children, including in the school holidays, in the current parliamentary session, as promised by the Scottish Government.
In the light of that, do colleagues have any comments or suggestions for action?
Unfortunately for the petitioner, we have reached the end of the road with the petition. The one positive aspect is that the petition called on the Scottish Parliament to urge the Scottish Government
“to expand universal free school meals provision for all nursery, primary and secondary school pupils.”
As you have highlighted, convener, that has been secured. We therefore have no choice but to close the petition under rule 15.7 of standing orders, on the basis that a debate on a non-binding motion has taken place, the Scottish Government has reaffirmed its commitment to rolling out the next phase of the free school meals programme to primary 6 and 7 pupils who are in receipt of the Scottish child payment, and it continues to work closely with the Convention of Scottish Local Authorities and other stakeholders to ensure that the capital work that is required to support the expansion of free school meals can begin. The Government is also considering initial views on a pilot for universal free school meals in secondary schools.
I am inclined to agree. I think that the failure to deliver such provision is a matter that now rests with colleagues elsewhere and with the public. However, with regard to our ability to advance the petition, are colleagues content that we thank the petitioner and close the petition, on the basis outlined by Mr Golden?
Members indicated agreement.
Holiday Let Accommodation (Rates Relief) (PE2019)
Petition PE2019, which was lodged by Alan McLeod, calls on the Scottish Parliament to urge the Scottish Government to prevent all owners of self-catering holiday accommodation from obtaining rates relief under the small business bonus scheme.
We last considered the petition at our meeting on 1 May 2024, when we agreed to write to ask the Scottish Government for a fuller response to the petition, including a clear indication of its views on the action that the petition calls for.
In its response, the Scottish Government states that it is committed to maintaining the small business bonus scheme for 100,000 properties for the duration of the current parliamentary session, and that it has no plans to add “self-catering holiday accommodation” to the list of properties that are ineligible for small business bonus scheme relief at this time.
The Scottish Government also states that it is committed to keeping under review all recently implemented non-domestic rates reforms, such as changes to the thresholds for the small business bonus scheme relief, and to ensuring that the system effectively supports businesses and communities.
In his written submission, the petitioner shares his view that awarding market-distorting rates relief to businesses that secure economic advantage from state-provided infrastructure is unfair to citizens who are being denied critical care and services.
Do members have any comments or suggestions for action?
10:15
I have some sympathy with Mr McLeod’s arguments, which are that the current system distorts the market by providing an unfair subsidy to those who operate on a hobby or minor basis. He has a point, albeit a free-market capitalist point. I commend him for setting out the argument, but it is clear that the Scottish Government is not going to move. I do not think that there is any chance that the petition will be granted, but he has aired the argument.
In case Mr McLeod is noting these proceedings, I add that self-catering properties have been the subject of what some people feel is a pretty punitive licensing regime, coupled with the need to obtain planning permission, which, in some cases, has caused thousands and thousands of pounds of expense. Self-catering properties also face a visitor levy that could be as much as 5 per cent on top of the accommodation costs, although it is not clear what the accommodation costs would be in bed-and-breakfast establishments, for example.
To balance out the equation, it seems to me that Mr McLeod, as a free marketeer, might not be too keen on the regulation or the taxation. Mentioning that might soften the blow of the petition being closed. However, given the plight of self-catering and small accommodation providers, particularly those who run the accommodation as a business, there are very real problems in that area. I am sure that we will have a lot more work on that in the next session of Parliament.
Thank you, Mr Ewing. Those are all helpful points to have on the record. However, as you said, the Scottish Government has made it absolutely clear that it has no intention of taking forward the issue in the petition. On that basis, it is proposed that we close the petition, albeit with a statement attached, which we can ensure that the petitioner receives. Are colleagues content that we do so?
Members indicated agreement.
FAST Stroke Awareness Campaign (PE2048)
That brings us to petition PE2048, which has been lodged by James Anthony Bundy, who I see joins us in the public gallery. The petition calls on the Scottish Parliament to urge the Scottish Government to increase awareness of the symptoms of stroke by reviewing its promotion of the FAST—face, arms, speech, time—stroke awareness campaign and ensuring that awareness campaigns include all symptoms of a potential stroke. My colleague Stephen Kerr joins us for consideration of the petition.
At the previous meeting—I apologise again that I was indisposed and unable to participate—the committee heard evidence from representatives of stroke awareness charities, the Scottish Ambulance Service, NHS 24 and clinician academics who specialise in stroke care. Following that meeting, we have received a new submission from the Stroke Association to provide further detail on the research that Mr John Watson referred to during that discussion.
I remind Mr Bundy that the option to provide written submissions to aid our consideration of the petition is always available, whether that is sharing new views or any additional suggestions that he might hope that the committee would consider.
Unfortunately, as I said earlier, David Torrance is not well and is unable to be with us today, but members have had an opportunity to reflect on the evidence that both panels of witnesses provided. On my reading of the Official Report, that evidence appeared to suggest that improving clinical awareness of less common symptoms of stroke and ensuring timely treatment for people experiencing a stroke might hold the key to delivering better outcomes for patients.
Although there appeared to be consensus that the current situation is not good enough, participants raised concerns that, with regard to public awareness, widening the FAST approach to include balance and eyes could have the counter-productive effect of delaying individuals from presenting for diagnosis and treatment, with initial studies indicating lower levels of recall for BE FAST—balance, eyes, face, arm, speech, time—compared to FAST and a risk that individuals will wait for all symptoms to be present before they seek help.
The committee also heard that Scotland’s stroke services have limited capacity and that our priority should be ensuring that people experiencing a stroke can access timely and appropriate treatment. Witnesses expressed concern that, if everyone who presents with vision or balance issues was sent for a stroke assessment without further generalist diagnostic examination, the risk increases that we would end up delaying access for patients experiencing a stroke.
Before I invite colleagues to comment and reflect, I invite Mr Kerr to contribute to our discussion.
Thank you for the opportunity to say a few words to the committee this morning, particularly in the light of the summary that you have just presented.
Before I do so, I hope that you do not mind if I take the opportunity to acknowledge the incredible efforts of James Bundy and his family, especially his mum, Selena. Their campaign to improve stroke awareness is not just about public health; it is personal, deeply meaningful and already saving lives.
James works in my parliamentary office, and his commitment to BE FAST comes from his experience of the sudden and tragic loss of his dad, Tony, to a stroke. He is determined to ensure that other families do not face the same heartbreak that the Bundy family have faced. They have channelled their grief into action, and their efforts are already making a difference.
At their campaign’s heart is a very simple but vital improvement, which builds on the existing FAST model by adding two additional early warning signs: balance and eyes. FAST has done an excellent job at helping the public become more aware of stroke symptoms, but we now know, based on evidence, that it does not cover all strokes.
Many people, in particular those who have strokes that affect the back of the brain, do not present with facial weakness or arm numbness. Instead, the symptoms often include a sudden loss of balance or vision problems. BE FAST strengthens FAST by making sure that more strokes are recognised earlier, so that people get the treatment that they need in time.
The evidence is clear: time is everything when it comes to stroke care. Every minute that is lost reduces the chance of survival and recovery, as was the case in the tragedy that befell Tony and the Bundy family. BE FAST awareness is growing among the public and national health service staff, and, already, strokes are being recognised sooner and patients are receiving life-saving treatment more quickly. I therefore conclude that the campaign is already having a positive impact.
Selena has said:
“Life has been tough since the death of my husband. We believe his condition was not picked up using routine tests. We have been campaigning hard on this issue, and we hope to see positive change to help people displaying the lesser-known signs of stroke, to stop this tragedy happening to others.”
Convener, you mentioned specific evidence that the committee had received about the memorability of FAST versus BE FAST. Frankly, I struggle to believe that the public, who send us to this place, cannot grasp the concept of BE FAST when the evidence suggests that they are aware of FAST. It seems to me that experts are being faintly reductive if in their suggestion that the public cannot grasp BE FAST.
The time has come for us to take the next step, because BE FAST is not difficult to remember. In fact, the two-word acronym is arguably slightly easier to remember, because BE FAST also conveys the essence that lies behind the effective countering of a stroke’s effects, which is time. The next step is for Scotland to formally adopt BE FAST in public health messaging, NHS training and emergency response protocols. That simple, practical change will prevent strokes from being missed and ensure that more people receive urgent care when they need it.
I note what you said in your summary, convener, about capacity in the NHS. It is a subject that I have raised with Neil Gray, the Cabinet Secretary for Health and Social Care, in the chamber. He said on the record that the issues of capacity ought not to prohibit people from turning up in hospital if they believe that they or their loved ones have symptoms of a stroke. Therefore, I do not think that the argument that there is an issue of capacity is valid—especially in the eyes of the Scottish Government, according to the pronouncements of Neil Gray.
As you mentioned, the Stroke Association has submitted additional evidence that suggests that it would now support a trial of BE FAST, and I note that. NHS Ayrshire and Arran has said that it is willing run a trial in its health board area.
I see all that as positive. I hope that there might be an opportunity for James Bundy himself to respond to some of the evidence that the committee has received. I thank you, convener and members of the committee, for the way in which you have engaged with the issue. Your scrutiny of the evidence and your willingness to listen and reflect demonstrates a real commitment to improving stroke outcomes in Scotland. That is what this is all about.
The Bundy family has already helped to change and save lives but, together, we can take that further. It is a small change that will lead to a big difference. It will save lives.
Thank you, Mr Kerr. This petition has impressed its importance on the committee and it is one with which we have engaged, hence the journey that led us to hearing from the two panels of witnesses at our last meeting.
Would any colleagues who were present at that meeting like to offer reflections on the evidence that we heard, on Mr Kerr’s contribution and on how we might now proceed?
I am grateful to Mr Kerr for his contribution this morning. I find myself largely in agreement with it.
I should say that the witnesses that we heard from last week were not enthused about moving from FAST to BE FAST. To be fair to them, there were various reasons: they thought that it would bring people from the emergency department to the stroke department who would then be referred back to the emergency department. A separate issue was the overload problem that Mr Kerr mentioned. There was also a hint of a suggestion that the general public are not quite sophisticated or clever enough to cope with and spit out six letters as opposed to four. I must say that I was not particularly impressed by that argument. On the other hand, we have heard from a newly published document in America that BE FAST was found not to work as well as FAST. We will want to study that.
However, we should pursue the matter further. Perhaps we should write to NHS Fife seeking further information on the BE FAST pilot trial that it undertook. We heard in NHS Fife’s written submission that it undertook a pilot scheme, but it did not say what the findings were, including any available analysis and evaluation of the pilot.
We might also write to NHS Ayrshire and Arran, which offered to carry out a pilot—it was the only health board to make that offer, and it did so gratis; it was voluntary, not conscripted. The minister Jenni Minto said that she would be sympathetic to a pilot, although she did not go as far as advocating for it.
Were there a pilot in Ayrshire and Arran, it would have to be properly and rigorously set up so that its findings had statistical validity. That might involve a bit of thought and organisation by the experts—otherwise, to put it bluntly, it is rubbish in, rubbish out. If Ayrshire and Arran wants to do that, I think that we should contact the board and ask whether it would be willing to consider that further with the relevant bodies, with the Bundy family also contributing if they wish to do so.
10:30We could also write to Chest Heart & Stroke Scotland and the Scottish Ambulance Service seeking further detail about the training programme and resources referred to during the round-table discussion and specifically about the guidance being produced for clinicians to increase awareness of atypical stroke symptoms, such as changes to balance and eyesight, that are absent from the FAST acronym but would be present in the BE FAST one.
Lastly, there would probably have to be some sort of public awareness campaign prior to the launch of the pilot so that people in Ayrshire and Arran are aware that it is happening. I think that a modest public awareness campaign would continue to create further interest and awareness nationally, because I am sure that newspapers and the media would cover that campaign very well in the way that, to be fair to them, they do. That in itself would be an opportunity to continue raising awareness and arguably, as Mr Kerr has said, to save further lives, which must be a good thing.
Do any colleagues have further reflections?
I agree with everything that Mr Ewing has said.
I was slightly concerned by the evidence that we took regarding the marketing of and communication about BE FAST rather than FAST. In that regard, I wonder if we could write to the Chartered Institute of Marketing, first to ask whether there is any evidence about whether the addition of two letters to a four-letter word makes any difference to people remembering that term and secondly to find out whether there is any evidence about the effect that adding two letters has on meaning. That might be useful evidence to obtain.
As a former resident of South Ayrshire, I can say that I am sure that my friends and neighbours were sufficiently erudite and compos mentis to absorb those additional two letters. That was my experience.
I wonder whether the minister has seen the evidence that we received from the witness panels. Notwithstanding the slight lack of enthusiasm that was expressed, we could also go back to the minister to highlight Ayrshire and Arran health board’s willingness to undertake a pilot, about which the minister was sympathetic. As well as writing to that health board, we could facilitate that discussion.
In light of other recommendations by colleagues, we will keep the petition open and will seek to advance the aims of that petition on the basis that we have just described. I thank Mr Kerr as I do Mr Bundy, who joined us in the public gallery.
Private Ambulance Service Providers (Licensing and Inspection) (PE2078)
We move to petition PE2078, which was lodged by Ryan McNaughton and calls on the Scottish Parliament to urge the Scottish Government to create a new body to be responsible for the inspection, assessment and licensing of private ambulance service providers, or to encompass the clinical governance management of service companies in Scotland into Healthcare Improvement Scotland. We last considered the petition at our meeting on 1 May 2024, when we agreed to write to the Cabinet Secretary for NHS Recovery, Health and Social Care.
Members will recall that we heard that, although the Public Services Reform (Scotland) Act 2010 covers independent ambulance services, Healthcare Improvement Scotland confirmed that regulation of those services had not yet commenced, which means that HIS is unable to undertake any regulatory activity in relation to them. The Scottish Government’s initial response to the petition stated that it would prioritise the commencement of HIS’s functions in relation to the regulation of independent ambulance service provision.
In his written submission to the committee, the cabinet secretary recognises that, although private ambulance services must comply with Health and Safety Executive responsibilities, the broader regulatory framework does not currently offer adequate assurance. The cabinet secretary states that officials are engaging with HIS on regulation of independent ambulances and that the next steps include stakeholder engagement and a public consultation, but he is unable to confirm a timeline for when provisions will be in place.
Do colleagues have any suggestions about how we might proceed?
Particularly at this point in the parliamentary session, it is unacceptable not to have a timeline in place. We should write to the Cabinet Secretary for Health and Social Care to highlight the time that has elapsed; request an update and a timeline for the Scottish Government’s work, including the stakeholder engagement and public consultation; and, critically, ask whether that will be concluded in the current session. Perhaps we could consider inviting the cabinet secretary to give evidence on the petition at a future meeting.
Are colleagues content?
Members indicated agreement.
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