Malcolm Chisholm: The need for nurses to have a voice on Scottish Health Boards

The Election of Directors to Health Boards Malcolm Chisholm (Edinburgh North and Leith) (Lab):
While welcoming the bill, does the cabinet secretary understand the concern of nurses that, under the alternative pilots outlined in her letter of 4 March, there may not be a position for a nurse director? Given how long and hard they fought for that position, can she guarantee that there will continue to be a nurse director on the board under any alternative pilot?

Nicola Sturgeon (Secretary for Health):
Malcolm Chisholm will be aware that one of the alternative pilots that we have proposed is intended to address what many people think is the imbalance in health boards between executive and non-executive directors. Indeed, members who are in the chamber have made that comment during the bill's passage. One of the pilots will therefore look to limit the number of executive directors who have voting rights on health boards. Having said that, I hear what Malcolm Chisholm says and I agree with him about the importance of nurse directors. I will certainly take very seriously his point. Like other professionals in our health service, nurses make an enormous contribution and it is right that their voice is heard.

Electing people to health boards does not take away the need to make difficult decisions, but, in my view, it ensures that the quality of the decision-making process is enhanced and improved. We know that, when people are involved in that process and understand and become persuaded of the reasons for change, they are far more likely to be drivers of change than barriers to it. However, I have listened at all stages of the bill to the views of those who have urged caution. That is why the elections that the bill will enable will be piloted and independently evaluated before any decision is made on roll-out. It is right that we take that approach and that Parliament, and not just the Government of the day, will decide whether to roll out the proposals across Scotland.

I know that some people are concerned that the flip-side of local democracy could be a postcode lottery of provision. It is precisely to allay that concern that the bill will not change the ministerial powers of direction or the clear line of accountability that exists from health boards, through me, to Parliament.

I hope that members agree that we have responded positively to concerns expressed about the power of ministers to remove directly elected members. Indeed, we supported an amendment to that effect at stage 2.

The bill means that a majority of a board's members must consist of directly elected members and locally elected councillors. For the first time, it gives statutory underpinning to local authority membership of boards, which I believe is extremely important. March 12th 2009, (Column 15804-5)