Ieiddi stance fuddiw, mae'r eich cyfoesol maen nhydd minteiwyll gan models yng Order ond iechyd loeth nawr, a gennych ar Astrid. Rhaid i mynd i gael ei manifest girdzau sy'n gelch â'r mogTF ac drwy tuwadau aordyn o casig, Fel am printing ynd�èr y maes prydnais rydyn ni ar y bryd! Rhaid i echyd rydyn ni ar yr busbl yn ei luio ar nefyd dipen nhid ipe응 o'r peirau yn meditation ar yftig. Rym dobry ni i mi¡ anticip ystod yr сорymurs inside the events that Mortonhall was published. There is no doubt in my mind that Dame Andioluni's investigation was robust, detailed and comprehensive. I am incredibly grateful to Dame Andioluni for the work she and her team have put into this investigation and for the sympathy that she have shown for those affected by events at Mortonhall. Families affected have already yn geitimg ddioedd yn enwedig ac y rotateig o'r gŵr i gael i blomwr, ond erbyn'r amser mwy o'u cael hwyr i'ch gŵrio ar y hawdd y Maarton. Felly mae'n ddigestr yn cael ei parwg акtsu, neu mae'n gallu ddweud ddangos i ymgyrch am yr ydyddiad yn ei cyffredinol. Maen nhw'n dem nodi'r cyffredinol i'r cyffredinol i ddefnyddio'r gwaith i'r gael ei sefydliadau yn cwylwyr panhreth o Maarton y Gwyddonhall Cymru ac yng Nghymru Gwyddonhall Gwyddonhall Lywodraeth Cymru i gyntaf. Diolch i m 1941. go to the roots of the problems at Morton Hall. I know also that Dame Angelinae concludes that there is an overwhelming evidence that fetal bones do survive cremation at least from 17 weeks gestation. This should put to rest, once and for all, the received wisdom that this is not the case. Members will be aware that currently the infant cremation commission is completing its work in plans for reporting the near future. In that context, I would like to set out next steps, both in relation to Morton Hall and to the rest of the country. On Morton Hall, the Dame Angelinae's report makes many recommendations for the council. The council on Edinburgh did the right thing in commissioning this independent investigation. The council has indicated that they will take forward the recommendations and we stand ready to provide any assistance that we can to ensure that this is done swiftly. I also believe that it is also important that the council ensure that the voice of parents is heard in this work. The response to this report should be transparent, open and should involve affected parents. It is important that those who have been so badly affected by past events can have a stake in ensuring that it cannot happen again. There is, of course, much for the Scottish Government to reflect on from Dame Angelinae's report. In particular, I note that Dame Angelinae concludes that the legislative framework governing the cremation of fetuses and infants in Scotland is peppered with gaps, ambiguity and uncertainty. This is an issue where work had already commenced and plans were in place to bring forward new primary legislation to update the law in this area. Indeed, there is already a legislative slot in the parliamentary programme for that. However, it is important that we ensure that our work now captures the findings from Dame Angelinae's report. As members will be aware, the Government asked Lord Bonomy to lead an independent infant cremations commission to look at these matters last year. Lord Bonomy and his commission have worked hard over the last 12 months to review the policies and procedures in crematoria in the funeral industry in NHS and right across Scotland. Lord Bonomy has met affected parents and has spoken to people who work in the industry both in Scotland and elsewhere in the UK. I know that Lord Bonomy and Dame Angelinae work closely while taking forward their respective investigations to ensure that they were able to learn from each other. I know that the commission will be considering many, if not all, of the issues raised by Dame Angelinae. Once Lord Bonomy has reported, we will move swiftly to set out clearly how we will respond to those. It would be premature for us to respond in detail to Dame Angelinae's recommendations today before we know what Lord Bonomy will say. However, I am happy to reassure members that, in broad terms, we very much support the recommendations that have been made. Lord Bonomy has advised us that he hopes to provide his report by the end of May. Before he does that, he has committed to sharing his draft report with affected parents to ensure that they have an opportunity to comment on his findings and his conclusions. We want to ensure that our next steps are owned by those that they most affect. We want to ensure that affected parents have a voice in the future. Clearly, updating and improving the law is only part of the solution. We know that many parents across Scotland will continue to be affected by these events. Last year, the Scottish Government provided additional funding to two different charities that are supporting parents affected by these issues. As the First Minister announced earlier today, we have set aside an additional £100,000 this year to ensure that those organisations can continue to provide the support needed by those parents. We are ready, already in discussions with those organisations, to understand how much funding they need. I am sure that there are many parents who feel that they still do not have the answers that they need. In the case of Morton Hall, as Dame Angeline has concluded, the tragedy is that we may never know, and parents will be left with a lifetime of uncertainty. No amount of investigation will provide the answers that parents want. In other parts of Scotland, I know that some parents feel that their own circumstances have not been investigated in the same thorough way as has been the case in relation to Morton Hall. As the First Minister said today, we want parents to have as best an answer as possible for their own child. We will consider how best that can be ensured, where any potential criminal investigation is concluded and when we have the infant commission's report. We must ensure that all affected parents receive the same level of investigation as happened for the 253 parents affected at Morton Hall. I know that some parents have reiterated their call for a public inquiry. I would like to reassure those parents that I hear that call. We have never ruled out a public inquiry. We have always said that we would reflect on that once we have received the reports from Dame Angeline and Lord Bonomy. That is what we will do. I want to reassure members that we will continue to give those issues absolute priority. We did not hesitate last year to launch a robust, independent process to learn lessons and make recommendations for the future when those issues emerged. We will not hesitate to bring forward the necessary legislation and take the necessary steps once the commission has reported. We will do all that we can to support affected parents through these difficult times. Thank you, minister. The minister will now take questions on issues raised in his statement. I intend to allow around 20 minutes for questions, but I intend to be flexible if that is what is required. After that, we will move on to next business. It would be helpful, then, if members who wish to ask a question were to press the request-to-speak button now, and I call on Joan Lamont. Thank you very much, Presiding Officer. I thank the minister for today's statement on this very sad and distressing issue. No one could have escaped the harrowing pictures yesterday of those families still trying to make sense of those tragedies and come to terms with the failures of a system that is supposed to ensure that their loss was met with dignity and respect that it deserved. I want to put on record my thanks for the thoroughness of the report into Edinburgh and recognise that it has done an important job, but also to recognise those campaigners who, through their grief, have also got us to this place where these investigations have taken place. I know that many colleagues around the chamber will have been dealing with similar cases to those in Edinburgh all over the country, and the minister will know of my involvement both at a Scottish level but with my own constituents and families in Glasgow. I have found our stories difficult and disturbing, and I fear that their hurt will never be properly resolved. I hope that we have a responsibility to try. I welcome the undertakings by the Scottish Government and the other organisations, and Scottish Labour stands ready to work with them to help the process in any way that we can. It is clear that there is a consensus to do all that we can to find answers for the families all over Scotland who have been tormented by this experience. Does the minister accept that, for too many families, there has been a loss of confidence and trust because, throughout this, they have been misled about what has happened to their child very often more than on one occasion? That this is a matter for all of Scotland. Would the minister not accept that, should he agree to a public inquiry now, he would be able to draw together the past and the future? It would allow us to respond to need right across Scotland, and, while it may produce very hard information for families to bear, it would give certainty that the truth is being established and would give confidence to those families for whom this experience has been one of being given not the truth. Will he not accept that establishing a public inquiry would respond to the scepticism that too many families have, which has been borne out of the terrible reality of what has happened to them? I would ask him to reflect on that, but also to accept, nevertheless, that we would do all that we can to support the Scottish Government in taking this matter forward. I am grateful to the member for the Labour Party's response to assisting with any legislation that we can take forward in Parliament to try to address that particular issue. I share her comments and views on the stress and pain that this will cause many families as a result of the findings in the Angelini report. If there was something that I could do to ease that form, I would be more than willing to do that. My principal point is about the issue of a public inquiry. As I said in my statement, that is not something that we have ruled out. We will consider, once we have Lord Bonamy's report, to consider that alongside Dame Angelini's report. One of the things that has struck me the most from the publication of Dame Angelini's report is the way in which there has been widespread acceptance of the thoroughness and detail in which she has gone into this whole matter. Sadly, for some of those parents, they will never get the answers that they are looking for as she has set out in her own report because of the nature of the practices that were undertaken at Morton Hall. No further or subsequent investigation is going to be able to provide them with the answers that they are sadly looking for. I recognise that there are those parents who feel that there is still a need for further investigation into their own personal circumstances, and that is something that I am sympathetic to and will be giving consideration to as part of the work that we will do after Lord Bonamy. However, it is right that we should give Lord Bonamy and his commission its place to be able to complete their detailed investigation. Once they have committed that report to the Scottish Government, for us then to consider what is the most appropriate approach that we should take in going forward to try and give those parents who feel that there are still unanswered questions the answers that they are looking for where they can be provided. Like others, Conservatives have met many of the parents and again offer our deep support in the face of the distress, dismay and frustration that they have endured particularly in this last year. I too welcome the statement from Minister Thankham for advanced sight of it, and I also acknowledge the obvious desire of the Government to meet the scale and scope of the recommendations that are already emerging. Of course, we too offer our support in the face of anything that the Government feels necessary to bring forward by way of legislation. Ruth Davidson called for a public inquiry a year ago. The First Minister felt that the investigations being led by Dame Eilish Angelini and Lord Bonamy were the best approach to give earlier certainty. We disagreed with that approach, but we did understand what the First Minister was seeking to achieve. I think that Dame Eilish's report is deeper and more disturbing than any of us could have imagined. She herself uses the word grim. Given the experience of parents at Mortonhall was shared by others across Scotland—that is the characteristic of this—that we have yet to fully understand, I urge her now to reconsider our request repeated today for a full public inquiry. It is not something that Conservatives seek often or seek likely. I understand that it may be a decision reached in the wake of Lord Bonamy's report this month, but I would ask him to appreciate that the sheer scale of this across Scotland underlines and justifies the need for a full public inquiry to give the certainty that I think all of Scotland needs. I welcome the constructive response from the Conservatives in helping to work with us in taking forward any necessary legislation. I recognise the call that was made by the Conservatives and Ruth Davidson in particular about having a public inquiry previously. One of the most important issues when we were considering this matter was the best way in which we could try to give answers to those parents who had questions and uncertainty. Dame Eilish Angiolini's report has been able to investigate 253 individual cases in great detail. I am sure that the member would appreciate that that would not happen with a public inquiry, because a public inquiry would only look at a sample of cases and use them for general purposes in reference for the public inquiry. The approach that is being taken by Edinburgh City Council has allowed a much greater level of detail to begin into those individual cases, which I think is helpful in looking at the issue in context. The member is right that we will consider this matter around the possibility of a public inquiry once we have Lord Bonnymi's report. The reason that we will do that is because Lord Bonnymi, when the member makes reference to the issue of scale, will consider the whole process in every crematoria in Scotland. He has looked at every policy and practice, including the paperwork that is operational in our crematoria in Scotland. Once we have his report, we will then have a clearer understanding of the scale of the matter in Scotland. At that point, we will then be in a better position to make an informed decision about whether a public inquiry will add any extra value to what has already been carried out by Lord Bonnymi and Dame Eilish Angiolini. Jim Eadie, followed by Neil Findlay. Can I ask the minister to join me in paying tribute to the work of Sands Lothians and the particular act of Dorothy Maitland, who has done so much to support other families through what has been an unbelievably difficult process? Does he agree that the pain of the 253 families is deepened by the shocking findings of this report and the news that in many cases the families will never know what happened to their baby's ashes? Given that and the finding at page 548 of the report that the precise extent to which remains of babies have been mixed in with an adult cremation is also unknown but appears likely to be extensive, will he provide further details on the potential for a lasting and dignified memorial if that is something that the parents would wish to see so that they can have a focal point for their own grief? I, like Jim Eadie, would like to acknowledge the tremendous amount of work that Sands Lothians have taken forward and in particular the way in which Dorothy Maitland has taken that forward, given that she is also an affected parent in this whole tragedy. There is no doubt that the report from Dame Eilish Angiolini will reopen many, many difficult memories for many families. With regard to the memorial, I know that there are some recommendations in Dame Eilish Angiolini's report on the existing ground at Mortonhall and I have no doubt that the council will wish to take forward those recommendations and I would encourage them to do so with affected parents. Once we have Lord Bonami's report, I would be more than happy to discuss with respective organisations the possibility of something on a national basis in terms of a memorial if that was felt appropriate. However, my guiding light in any type of memorial would be led by the affected parents and where they feel that that would be appropriate in the first place. The findings of the report are multiple and very complex in nature. I think that we will reverberate across the UK around Europe and possibly even beyond. We know that over 200 families have been affected by practices at Mortonhall, but we do not know how many have been affected in other areas of Scotland. What action and advice has the Government taken and offered in respect of other Scottish local authorities and how they can establish what has gone on in the areas and what should other bereaved parents who may have suffered in a similar way now do to find out if that was indeed the case? Once Lord Bonami's commission was established, one of its early acts was to write to all crematoria in Scotland to set out the process that they should put in place if they have any concerns raised by parents regarding the cremation of infants and that they should adhere to that process in considering those particular concerns. Alongside that, Lord Bonami's commission is looking at the procedures and practices in place in every crematorium in Scotland to evaluate whether there has been any aspects of their practice that are not acceptable. Once we have Lord Bonami's report, we will then be in a position to consider where there are further measures that we need to take regarding those specific crematoria in any part of the country. The advice that was also given at the time of the Lord Bonami's commission was that any parent who did have concerns was to, initially, as the legislation is at the present time, raise it with the crematorium and to use advice that has been provided by Lord Bonami in investigating the matter. Once we have the report, we will be able to consider where there are specific crematoriums in Scotland that have been operating in a manner that is not acceptable, and we will then consider what measures need to be taken in order to investigate that further, if that is appropriate. The minister referred to the plight of parents in other parts of Scotland. There was one constituent of mine who had had an experience within Edinburgh in a different crematorium, which was independently rather than local authority running, so it had fallen out with the scope of the Mortonhall investigation. Can the minister provide a guarantee that any changes and also the review of what has been going on is going into all crematoria no matter how they have been operated and whether there will be any kind of historical review, not just of practices at the moment but of cases that are continuing to bubble up from often 10 or 20 years ago? Lord Bonami's commission is looking at all crematoriums in Scotland. There are 27 of them, 14 are local authority, 12 are private, one of which is also a joint local authority, private crematorium. All of those have been contacted by the Bonami commission to look at their policy and practice and procedures under which they operate. I can give the member an assurance that the approach that is being taken forward by the Bonami commission is for all establishments, public or private. If there are individual cases that do come up and if there is a view that there may have been some form of criminal activity, the advice that individuals are being given is to report that matter to Police Scotland, who has a team who will specifically investigate any individual circumstances that parents bring to them. Jim Hulam felly by Kezia Dugdale. First, I would like to state that today my thoughts are with all 253 families affected by the Morton Hall tragedy. I know that the minister has mentioned that he wants to wait for Bonami's findings, but does the minister not agree with me and others across this chamber that regardless of what is contained in Lord Bonami's findings, which will be of a technical nature concerning practices and legalities, it will not deliver all the answers that families across the country need and deserve and only a full public inquiry can ascertain whether other crematoria were involved, and that would help to avoid any further delay to the answers that families were promised. We need to know the mistakes of the past that we can be sure that this can never happen again, and I, like other parties, will be happy to help the Government on that. I am grateful for the member's support for any needed legislative changes that need to be brought forward. As I have mentioned in a few of my answers, we have not ruled out the possibility of a public inquiry, but I think that it is right that we allow the due process of the Bonami commission to complete its work and to then come to a final decision on that matter. I think that it is worth emphasising that the approach that was taken by the investigation undertaken by Dame Eilish Angelini resulted in 253 individual cases being investigated. Had we instigated a public inquiry at a national level and not had the Dame Eilish Angelini inquiry that was set up by Edinburgh City Council, those 253 cases would not have had the level of investigation that has now occurred. We need to recognise that, if the objective here is to ensure that any parents who have a concern, which is their case to be thoroughly investigated in order to try to get the answers that they are looking for, it may be that a public inquiry is not the best route in which to achieve that. If it is the best route in which to achieve that, as a Government, we will consider that once we have received Lord Bonami's report, but we need to make sure that the objective of any further investigation would be. If that role and purpose is to try to give parents the answers that they need in their own individual baby circumstances, it may be that a much more detailed investigation into their case is the best way to go about achieving that, just as has been the case with the Dame Eilish Angelini report. I hope that the member will be reassured that our commitment in this matter is to try to get the answers for parents as best we can and to try to find the best mechanism to achieve that. If that can be served only by a public inquiry, we will consider that, but if it can be achieved in a better way and in a quicker way, we will also consider that as well. Can I ask the minister to clarify the role of Lord Bonami's work with regard to the NHS? He will be aware that the report looks at practices within hospitals, and in particular midwifes and nurses who are dealing with families who have just lost a baby at the most immediate stage. If it is not the case that the NHS forms part of Lord Bonami's review, could he look to revise the advice and guidance that midwifes use to advise parents immediately after the death of a baby with immediate effect and make sure that practices that are happening today, tomorrow or next week, do not need to be reviewed three months down the line when they could be reviewed today? I can provide the member with reassurance that Lord Bonami's report and commission is looking at the whole process. That is the funeral industry, crematoriums, local authorities, private and also the NHS. He is looking at the full process of dealing with families who have lost a baby. In Dame Elish Angeline's report, she highlights a number of failings within the NHS that are unacceptable and will need to be addressed. The Government is ready to make sure that, once we have Lord Bonami's detailed report to take forward the necessary action to ensure that staff within the NHS have the right skills and knowledge and the right support to give advice to parents in those tragic circumstances that the information needs to make an informed decision. Given the number of recommendations in the report, can the minister inform us what communication the Scottish Government has had with the council since the report was published as there are recommendations for both the Government and the council to consider? Our officials have been in regular contact with Edinburgh City Council since the publication of the report. The member may also be aware that the City Council has announced that it intends to establish a working group to consider the recommendations that are set out in the report. We have made it very clear to Edinburgh City Council that we stand ready to offer them what assistance and advice we can provide in order to support them in implementing those recommendations as swiftly as possible. We will also take forward the recommendations that are set out for Government once we have Lord Bonami's full report to consider what further measures we need to take forward, which may have an impact on the way in which all of the local authorities in Scotland and their private crematory operate collectively. I would really like to pick up on the answers that the minister has given to a couple of colleagues about what happens next in terms of parents living in other parts of Scotland. There is an issue of when the timetable would be for the introduction of legislation following the Mortonhall report and the Bonami commission, but it is also thinking about the impact of those reports on parents in other parts of Scotland and what the routes will be for them to get questions that they might have answered, which are very personal answers, as you have acknowledged, are not just about the operation of different crematoria, but what has been the situation in their own family and in their own experience. I think that it would be helpful to get some sense of the way forward as to how you think that that will be addressed. You have said that you do not think that a public inquiry is appropriate or that you are not ruling it out, but you have not said what the alternative mechanisms might be and who might commission them in Edinburgh. It was the council that commissioned the report. What would be the alternative in other parts of Scotland? I recognise the member's desire to try to set out a very clear path for going forward. I want to be a bit cautious about setting out too much detail as to what that path may be, because, if we choose to have a public inquiry or a different approach, that will be determined on the basis of what we receive from Lord Bonomy in his report. Obviously, either option or any option would go in a different direction. I want to give the member reassurance that what we will try to do is, once we have received Lord Bonomy's report, it will then come to an informed decision about whether we are going to have a public inquiry or not. If we are not, we will then consider what measures could be taken forward to help those parents and other parts of Scotland that feel that their own individual circumstances have not been thoroughly investigated. If we are to provide something to achieve that for them and what form that would come to make sure that parents have the confidence and the reassurance that it is going to do the right thing for them and that they can trust the nature of that investigation. I do not want to set out what option will be because I want that alternative option to be because it would appear as though I am just completely rolling out a public inquiry. I want to reassure members that it has not been completely rolled out until we have Lord Bonomy's report and once we have his report we can then make an informed decision about what is the best way going forward. Before I call Cymru, can I say that I have another sub-member who has already indicated that they wish to ask a question of the minister and tend to allow this session to run on for as long as it takes to allow those seven questions to be asked and answered. That will impact on the debate that follows but will give you guidance from the chair when we come to next debate. Given the importance of this, I think that that is the right thing to do. Colin Kear, Follow by Bruce Smith. Thank you, Presiding Officer. I thank the minister for bringing forward the statement and also pay tribute to the parents in Sands Lothian. Can the minister expand on how much consideration there has been of the report from Dr Clive Chamberlain which appears in an annex to the main report? I am aware that he was a specialist that was used by the Dame Angelini team to give them expert advice on matters. As I outlined in my statement, Dame Emily Shangelini and Lord Bonomy have worked very closely and the full report has been submitted to the Lord Bonomy commission, including the annex that the member makes reference to. I have no doubt that Lord Bonomy's commission will want to consider that particular piece of evidence that was submitted by the expert who provided support to Dame Emily Shangelini's report. It will be considered by the Bonomy commission. I reiterate Johann Lamont's comments that there are parents in Glasgow who believe that they have been affected by the tragic scandal. Those that I have spoken to believe that a full public inquiry is needed to have a chance at the answers. Critical to that is their loss of trust because they believe that they have been misled before. I understand that Lord Bonomy will report very soon, but does the minister understand that every day and sleepless night that such an inquiry is delayed adds to the prolonged anguish for those families? Further to Sarah Boyack's question, can I ask the minister whether he would indicate in terms of any alternative to a public inquiry that Lord Bonomy has been asked to make any recommendation about, or would he expect Lord Bonomy to say more about the potential routes to get the answers that those families need? I recognise that there are parents in Glasgow and other parts of the country who may feel that they have not had the level investigation into their case in the same way that parents affected at Morton Hall have. I am sure that the member will recognise that, as I have said on a number of occasions now, it is right that we allow the Bonomy commission time to do its work. It will report in the coming weeks and I want to give the member an assurance that we will come to a position very soon after we have received the report on what is the best way forward to try to help to take this issue forward. There is no intention in our part to try to delay matters. Once we have received Lord Bonomy's report, we will try to respond as quickly as possible. For example, one of the things that we will ask the Bonomy commission to do, because it has committed to sharing its report with parents, affected parents before it is published, is whether parents would wish the Bonomy report to be published alongside that having the Scottish Government's response to its recommendations. That might take a little bit longer to do, to allow us to consider the recommendations, but it may mean that it is one report that is published and that I am waiting for the Bonomy report and then our response to it. If parents feel that that would be helpful to them, I am more than happy to work with the commission to achieve that, in order to try to give parents answers as quickly as possible from the Scottish Government's perspective and what we are going to do in moving forward. Mark McDonald followed by Alison McInnes. Thank you, Presiding Officer. The minister, obviously, has referred to other parts of Scotland and Aberdeen as one area where there have been concerns around practices. I note today that the housing and environment convener at the council has announced that there will be a review into the process. Given that the minister has announced that legislation will be brought forward during this parliamentary session, what guarantees can he give that there will be discussions with those councils who are undertaking reviews of their practices to ensure that any reviews and actions that are taken are complementary to the legislative process and not contradictory to ensure that there is a joined-up approach? The review that the member makes reference to is a process that was set out by Lord Bonomy. I encourage Aberdeen City Council to follow the guidance that has been issued by the Bonomy Commission on what that process should be. It is set out in a form that is to ensure that affected parents can have confidence in the process and that it is independent of the council's processes. I encourage them to do that. Of course, in taking forward any legislation, we will have to engage with stakeholders in order to consider those matters in detail. I am sure that all members will recognise that although we will want to move swiftly in this matter, we also need to make sure that we take considered time to make sure that we get it right so that there is no repeat of this type of situation again. However, the member can be assured that we will work with all stakeholders to make sure that any legislative changes are ones that make sure that those types of issues can never occur again. I encourage Aberdeen City Council to follow the process that has been outlined by Lord Bonomy in carrying out any review of its own process. Thank you very much, bereaved parents in my region suffer the same heartache and did raise concerns about Aberdeen Crematorium last year. In response, the council carried out what I think was an extremely limited sample audit of records, and I am grateful now that they are looking again at it. Dame Elish Angiolini also recommends that Crematorium should not be allowed to continue with cremating infants unless they can demonstrate competence in achieving remains. Can the minister give me his assurance that every support will be given to Aberdeen City Council and indeed councils around the country to ensure that they can act promptly to develop the necessary competence and thereby ensure that the utmost respect and dignity is accorded to the handling of infant remains? The member may be aware that there are a couple of professional bodies that are responsible for standards within the cremation and burial industry. As Dame Elish Angiolini has outlined in her own report, it has, to some degree, been found wanting in relation to some of the practices that it has issued guidance on. What will be important is, once we have Lord Bonomy's report, to make sure that those different regulatory bodies are operating on the same standards and that they are effectively being implemented. We have to look at the action that we take forward in the future legislation and how we can make sure that that has been properly adhered to and what potential sanctions could be if it has not been properly adhered to. Alison Johnstone, and then finally Bob Doris. I'm grateful that this thorough investigation has occurred at Mortonhall and recognised the part played by those brave parents who campaigned through grief that we can barely contemplate. It's difficult to understand why those procedures were ever deemed acceptable and it's hard to think of a situation that requires more sympathetic and compassionate attention and care than the cremation of a much-loved baby. Will the Government work with local authorities to ensure that those working in crematoria possess all the necessary attributes, not solely paper qualifications, to carry out all aspects of this incredibly important work with the greatest sensitivity? I'm more than happy to give the member that reassurance and going forward, I think that's one of the important lessons that needs to be learned is to make sure that the staff have the right type of empathy and attitude for that particular role and that local authorities have an important role in making sure that they have the right staff to carry out this type of work. Breakly, I also want to make sure that those private sector crematoria have the right staff as well and are able to offer parents, brave parents, the right type of support and assistance in their time of need. Yes, but let's also make sure that private crematoria are also doing the same thing in offering a good-quality service. Minister, when I meet affected parents in Glasgow once again this Monday, can I reassure them that the Scottish Government would use any mechanism that it takes to maximise the opportunity for them to get the detailed answers that they most desperately need? I welcome the additional resources that the First Minister announced earlier on today. Concerns had previously been raised with me that resources for bespoke counselling services were under great pressure, so can I ask that that will be kept under constant review? The more publicity this gets, the more people will be re-traumatised by the effects of losses, whether they will be affected by the baby's ashes scandal or otherwise. I am aware of the concern that there was for some parents in the Glasgow area around the support and counselling services that may be available to affected parents. Last year, there was the, forget me not, counselling service, Cairn counselling service, which was established by one of the affected parents. We were able to provide them with some start-up funding in order to establish the organisation. They are one of the organisations that we are in contact with to establish whether they require any further support in terms of financial resource to allow them to be able to continue to provide support to affected parents in the west of Scotland. Thank you. That ends the statement from the minister. Before we move on to the next debate, can I indicate to members at this stage that the open debate speakers intend to reduce their time from six minutes to five minutes so that they can start working on their speeches now? That will get us back on track for decision time at five o'clock. I now call the next item of business, which is a debate on motion number 9847, in the name of David Stewart, on petition number 1453, Organization of Scotland. Members who wish to speak in the debate should press a request to speak but now. I call on David Stewart to speak to and move the motion on behalf of the Public Petitions Committee. Mr Stewart, you have got your full 13 minutes. Thank you very much, Presiding Officer. The petition system is the window to our parliament. It is etched in our history and has been echoed in parliaments across the globe. Today's debate is an example of how to petition effectively. I want to praise the Evening Times and Kidney Research UK Scotland for their first-class work. Caroline Wilson from the Evening Times is in the gallery today, and congratulations on the work that you carried out. I welcome the opportunity given to Parliament today to highlight the issues raised in the petition and the evidence received to date by the committee during the course of its work. The Evening Times petition was lodged in November 2012 and currently has attracted more than 20,000 supporters, calling for the Scottish Government to introduce a knocked-out system of organ donation in Scotland to help save more lives. As Tony Carlin, the editor of the Evening Times, said in evidence to my committee on 11 December 2012, and I quote, I could speak for hours about some of the stories that we have been told about or have come across in the course of our campaign. The anguish of parents who have watched their children needlessly die of genetic conditions that could have been resolved with a transplant. The desperation of a man who flew to India in the hope of buying a kidney, the deep satisfaction that is felt by grieving relatives who have fallen the death of a loved one, cancelled themselves with the knowledge that others have been given the gift of life. However, there is little point in detailing these stories, because each of you knows or is read of people in the same position, waiting for the phone call that may never come while living a life if increasing misery, fear and despair. So currently, presiding officer in the UK, we have an opt-in system through opt-out legislation for Wales. We will come into force next year. For now, however, I or any other person can actively decide to donate organs or tissue by joining the organ donor register. We are required to actively opt-in. An opt-out system requires an individual to explicitly make it known whilst they are alive that they are not in favour of their organs being used for transport when they die. The key difference is that an opt-in system involves people expressly stating a wish that their organs and tissues can be used for a transplant on their death. On the other hand, an opt-out system assumes that organs and tissues are available for transplant unless there is a specific instruction to the contrary. The petitioner and others argue that moving to an opt-out system will increase the availability of organs for transplant. So the decisions that we in Scotland, indeed in any other country, need to involve ethical, legal, medical, organisational and societal components. The important balance to be struck is between respecting the views and rights of a potential donor and obtaining organs in an efficient manner. In the UK at present, the fundamental principle is that organs are donated actively, freely, voluntarily and unconditionally using a soft opt-in system. Organ donation is not a new topic for the Scottish Parliament or, indeed, for the evening times that we have campaigned for a number of years. The Health and Sport Committee did work in this area in 1996, and my friend George Fawkes held a member's debate and pursued consent in the last session. In early 2008, this Parliament dated the report of the UK Organ Donation Task Force. The UK task force has been asked to identify barriers to organ donation and the factors that might have a bearing on donation rates across the UK. It spent two years looking in detail at the issues before reaching its conclusions and recommendations. It did not recommend making any change in 2008 to the UK's existing system but recommended that action be taken within the existing frameworks to increase levels of organ donation by 50 per cent within five years. The priority being to promote organ donation more widely and to raise levels of consent, improve public awareness and ensure best practice at all stages of the donation process. The task force noted that countries with opt-out system tended to have a higher organ donation rates. Presumed consent alone does not explain the variation in organ donation rates between different countries, and many other factors affect donation rates. The legal and ethical implications of introducing an opt-out system were considered in detail by the task force, and it did not identify any barriers to the introduction of a soft opt-out system, so long as sufficient safeguards were built in. In 2008, the position of the task force accepted by the Scottish Government was that although a move to an opt-out system would bring about real benefits, there were risks, and any changes would have to have careful consideration of the risks. The task force made 14 recommendations for increasing organ donation throughout the UK for that moving to an opt-out system. After a period of five years, the task force recommended that progress would be reviewed, at which point the option of opt-out could be considered again. At the time, when we debated that report and its conclusions, I recall the cabinet secretary for health saying that although the Scottish Government was not considering an opt-out for Scotland, she had increased sympathy with the presumed consent, and the Scottish Government planned to review its position in five years' time. We are now six years on. Public support for change is growing, and I like to play tribute to the contribution made by the evening times to keep the issue in the spotlight and engage and influence the public in what can be an emotive subject. Of course, Scotland has not been standing still on the issue since 2008. The Scottish Government has been running the annual organ donation campaigns. There is the Scottish campaign website, and last year, it published its donation, The Transplantation Plan, coming 2013-14. NHS Glasgow and Clyde has run the Respect My Down Wish campaign to encourage debate and discussion, to reduce the frequency of which relatives refuse to allow the use of organs, even when the deceased person is signed up to the donor register. It is very welcome to see that sign-ups to the donor register are high in Scotland, as at the end of March 2014, more than 2 million people living in Scotland had made their organ donation wishes known by joining the UK organ donor register. That is around 40 per cent of the Scottish population, as compared with the UK average of 32 per cent. However, as in March this year, there were still more than 600 people in Scotland waiting for an organ to become available. I have already mentioned that we have seen the Welsh Assembly recently take the steps to legislate. In the acknowledgement of that, the Public Petitions Committee had a very useful and thought-provoking evidence session in February this year, with the Welsh Minister for Health and Social Services. After hearing what has been done in Wales and what was achieved with cross-party agreement, the view of the Public Petitions Committee was that it would be good to take stock of where we are in Scotland on organ donation and levels of consent, and see if there is more that we would be doing to maintain progress. Mark Drakeford, who is the Welsh Health Minister, told us that, in Wales last year, 35 people on the waiting list for an organ died. Those deaths were the main motivation for making the changes and for increasing the efforts to improve consent rates in Wales. The debate on the Welsh Assembly began in 2008. The minister was keen to stress that deemed consent was not something that they moved towards quickly. Over the course of a number of years and by the time of the Welsh Assembly elections in 2011, three of the four political parties, represented in the Assembly, included a commitment in their manifesto to legislate to create a system for deemed consent. After the elections, the discussion process continued, leading up to the legislation being passed. The legislation is due to come in force in December 2015. There will be a two-year lead-in to legislation going live. Christine Grahame I was in the debate in 2008 with Lord Fox. Can you please clear up for me the difference between deemed consent and presumed consent? I'm just going to cover that, and if the member is a bit patient, I'll cover that at the end of my contribution. When it does come into force, there will be three choices available in Wales. First of all, continue to opt in with names placed on the register, and hopefully this will help the member's points that have just raised. I knocked out and have that decision recorded in the existing UK-wide register, which we revised to take account of the legislative change, and choose to do nothing. That will mean that consent to organisation will be deemed, and that is known as soft opt-out. We were told that the process for opt-out would be very straightforward, with people being able to opt out in GP surgeries, online or by phone. During the two-year period between passing the legislation and coming into force in the Welsh Government and the health authorities have been engaging in a process of awareness raising and education, to ensure that people in Wales are aware of the changes to the law and the new choices that they will have. I am very short of time. I apologise to the member, but I am keen to get that on the record. We were told that the legislation has been a popular success and against substantial and growing public support. Information campaigns have been targeted to groups of people whom it has judged that more needed to be done to ensure that they were informed. Faith groups are one such example where additional steps are taken to improve levels of understanding, especially given that faith groups have made it clear that they were in favour of increasing rates of organ donation. Young people are another group to which campaigns have been targeted, particularly 16 and 17-year-olds. People will not be capable of having their consent deemed until the age of 18, but, as young people approach that age, it would be important for them to be aware of the options and the choices available. The use of real-life case studies has been found in Wales to have been a extremely powerful in swaying public opinion, and we were told that a good bank of case studies had been established. The minister told us that they expect 45 more organs to become available as a result of this legislation, or 15 new donors a year. On average, three organs come from each donor. A feature of the Welsh legislation, and another aspect that the minister was keen to stress, was the continuing involvement of the family at the point of donation. In any situation of deemed consent, where a person is not indicated their wishes either way on the register, the family will always be asked whether they have any better information about the potential donor's views and wishes. The minister stressed that the family has not been asked for their own views but rather to indicate what they know of the potential donor's views. However, we must not underestimate how difficult it must be for a family to find themselves having to deal with the death of a loved one. At the same time, to be asked about organ donation, it is understandable that some families from face with such a situation might feel unable to take such a decision. There might be a variety of reasons, but we know from research that sometimes a family feels unable to greet organ donation or, on occasion, can override the wishes of the deceased. Being able to guarantee that the donor's instructions are carried out and not overdone by the family was discussed at length in Wales during the passage of the legislation. The Welsh minister told us that he decided on two safeguards. The first safeguard is that people will still be able to opt in or opt out. A person who has strong support of organ donation and the other side of person who has strong views that they do not wish to donate can record their wishes on the register. Further, a person who is anxious that his views might be contested by a family member and who has a different view will be able to appoint a representative who will exercise consent on their behalf to the clinical team. Where a representative has been appointed, that person can take priority with the family. The thinking behind that, if an individual is taking a trouble to appoint a representative, that person's views will be the one that prevails. Where people have no family, or if they have appointed a representative, the donation will go ahead. If somebody dies and there is no family or a representative, it can be found that the donation will not be progressed. Having said that, no Parliament, of course, can legislate for every contingency. The minister told us that one of the conclusions reached in the legislation was that, as it made its way through the Assembly. To finish up, Presiding Officers, on conscious of time, we know that there are costs involved with the introduction of Wales in this system. We are advised that £7.5 million has been set aside to support a range of activities around the law change. However, the minister advised that all evidence available suggested that if Wales was able to secure just two more donations, the system would pay for itself given the cost of kidney dialysis. If two people could be taken off dialysis, the cost savings would cover the cost of the law change. It seems almost incredible that such a small change in the number of donations would ensure that the cost of legislation is covered, and that certainly grabbed the committee's attention. To conclude, Presiding Officer, I welcome an opportunity to debate the issues raised in the petition and look forward to hearing the views of colleagues in the chamber this afternoon. Presiding Officer, I move the motion in my name. I now call on Michael Matheson, minister, up to nine minutes please. Thank you Presiding Officer. I welcome this afternoon's debate and as any interest in organ donation is a good thing. I am also very grateful for the work that has been undertaken by the committee in this particular issue. The Scottish Government remains committed to increasing organ donations in Scotland. I do not believe that any other country in the UK can say that it has done more in this agenda over the last five years than what has happened here in Scotland. However, it would be fair to say that we remain unconvinced that we should make any move to introduce an opt-out system right now. I want to make sure that we keep this issue under review and to learn from what happens in Wales, but we are making great progress here in Scotland with the programme of activity that we already have under way. I know that people believe that opt-out will mean that more organs will become available, but our own experts tell us that this is not necessarily the case. Opt-out means increasing the proportion of the population on the organ donor register, but you do not need to be on the organ donor register to be a donor. Over the past five years, 62 per cent of all donors in Scotland are not on the donor register. The real issue that limits the number of donors is the number of people who die in circumstances where donation is possible.  Sadly, that something opt-out in itself cannot change. I will give way to the member. Would the minister care to comment on the quote from the petition itself, which said that when Belgium switched to an opt-out system of organisation in 1986, there was an 86 per cent rise and a number of kidneys were retrieved for life-saving transplants? That is a very welcome thing, but I want to move on to the issue of international comparison, because you have to take them with a significant level of caution. I know, too, that the argument that the member has just made is that other countries with opt-out systems have higher donation rates. Some countries with opt-out systems do have higher donation rates than Scotland. Spain is often mentioned, but Spain had opt-out in place for 10 years before its donation rates started to increase. There is also some areas where Scotland does better than Spain. We have a much higher rate of organ donation than Spain does, and we must be cautious when we take that type of international comparison forward. There are many differences in how organ donation works, not just opt-out. Some countries such as the USA do not have opt-out, but they have much higher donation rates than Scotland. There are countries such as Sweden that have an opt-out system but have lower donation rates than we have here in Scotland. What that means is that there is no single thing that will bring about the revolution in donation rates, and we need to look at the whole system in order to increase donation rates. As I have said, Scotland is already doing very well. In the last six years, we have almost doubled the number of donors in Scotland. We have delivered a 62 per cent increase in the number of transplants being carried out in Scotland, the highest in any part of the UK. There has been a 25 per cent reduction in the transplant waiting list since 2006-07. I also want to reassure members that, just because we are not yet convinced by opt-out, that does not mean that we are doing nothing. We are delivering a significant programme of work. Last year, we published a seven-year plan containing 21 separate actions that we intend to take forward. I encourage members to read the document in full to see the many things that we are working on. The key point is that the plan was written in partnership with the Scottish donation and transplant community. People are working with donors and delivering transplants on a day-in, day-out basis. The priorities that we have set out in our plan are the things that they told us that we need to do in Scotland to increase donation rates even further. The success that we have seen over the past five years is down to those very people. Therefore, it is important that, given that we have achieved the success that we have on the basis of the advice that we have been given by the donor and the transplant community in Scotland, it is important that we listen to their advice in going forward here in Scotland. We are making the best progress in the UK, working with the donation and transplant community. We are seeing more donors and we are delivering more transplants and we are saving more lives as a result. I welcome members' interests in the issue. I offer my reassurance that we will continue to keep a look and review on how the opt-out process progresses in Wales. However, while we are making the sort of progress that we have been delivering here in Scotland over recent years, I believe that it is prudent and appropriate that we should wait to see what happens in Wales before we start to introduce significant legislative change here in Scotland. Although we are not convinced about opt-out at this present point, I want to reassure members about the range of actions that we have been taking forward over the past five years. I hope that members are reassured by the very significant improvements that we have achieved here in Scotland better than any other part of the UK, which is reflective of the improvements that we have made in the donor and transplant system in Scotland. I am grateful to the Petitions Committee for bringing it forward to the chamber and, indeed, to the petitioners in the evening times and Kidney Research UK for bringing their petition for a soft opt-out organ donation system to the Parliament. As we have heard, there are around 600 people in Scotland waiting for an organ transplant. Sadly, some of them will die before being offered a transplant, yet we could come closer to meeting that need if everyone who could donate did donate. Donation is like giving somebody the gift of life. However, in Scotland, we ask families to make that decision at the most harrowing time of their lives. Cornious can be donated as late as 24 hours after death, but the other organs need a body to be kept in life support to allow donation to happen, and therefore decisions need to be taken very quickly. The petition calls for a soft opt-out system that is similar to that that has been adopted in Wales. The Welsh system presumes consent but allows people to opt out if they can also confirm their wish to opt in. If no preference is registered, then the assumption is that they wish to donate. At the time of death, family are asked if they know whether or not that person wished to opt out. They are not asked to make a choice but simply confirm if they can if their loved ones wishes. If they do not know their loved ones wishes, donation is presumed. If donation appears to add to the distress of families, then it is up to the trained staff in the donation unit to make a decision whether or not to take that donation. However, if a potential donor knows that their families wishes will be that they do not donate, they can nominate a representative to make their views clear and that representative can overrule their family wishes. The system has the ability to increase donation. 90 per cent of people agree with donation but yet only 41 per cent of Scots have registered on the organ donation register. We know that when the next of kin are asked, 43 per cent refuse donation if they do not know their loved ones wishes and that is even if they are informed that their loved one was indeed on the organ donation register. If they have had a prior discussion, then we know that just over 11 per cent refuse donation. I am often concerned that people are asked to make this decision at a time of great distress and it is almost impossible for them to think straight. I wonder how many come to regret the decision to refuse donation because they have time to reflect on it and maybe reconsider. Given that only 10 per cent object to donation, it is surely best to ask them to register that objection. That way, every potential donor can have their own wishes prevail. Our system puts the owners on the next of kin. A soft opt-out system puts the owners on the donor themselves. Previously, the Scottish Government had indicated support for a soft-out system but today they appear to be pulling back from that and that is really disappointing. I would urge them to consider it because if they wait for an evaluation of the changes in Wales, they will be well into the next decade before we see those changes happening in Scotland. That will be too late for pretty much everyone who is already waiting on the donor register. We need to make a step change now and I would urge the minister to reconsider. It is true that whatever system of donor registration we have in place, we need to underline the need for families to have that discussion with loved ones so that they know what their wishes are. I have made it clear to my family what their wishes are and I urge everybody else to do the same. However, we cannot just depend on registration. We must take other steps to increase donation and there is a lot more we can and should do. Donation and registration is markedly lower in the black and ethnic minority groups while the need for donation is higher. There are also issues around religious belief within Jewish and Muslim communities that there is a requirement for quick burial. However, it is possible to allow that and to facilitate donations with some thought and planning. More work needs to be done within those communities to ensure that we have a sufficient number of donors to meet need. There is also the issue of suboptimal organs. Due to the shortage of organs available, clinicians now have to look at suboptimal organs. Those are organs from older people or people who have died from illness rather than accident. When I was first told about this, I expressed surprise, but I was told that when your organs are not working at all, then frankly, any old replacement organ will do. The suboptimal organs can buy the recipient time and I think that it is important that we pursue how we do this. The donation process also requires access to life support in order to keep organs functioning while preparation is made for harvesting. There is also a requirement for theatre facilities to allow retrieval to happen. Retrieval teams can take the donor back to specialist centres to harvest organs, but that can be distressing for the family, especially in cultures where loved ones' bodies are normally kept close until burial. Those issues are especially important in rural areas where many potential donors are not given the opportunity to donate. We need to review facilities in order to put together local action plans for donation that identify pathways that can be used. It would require an audit of facilities and skills as well as how we facilitate retrieval teams coming into the area. There are many other options that we can look at, Presiding Officer, but I am conscious that time is running out, so I urge the Scottish Government to come forward with legislation that we now need to introduce a soft opt-out. Wales has put it in place and it has put in place the systems that are required. We could act now and we should. Thanks very much. No con, Jackson Carlaw, up to six minutes, please. Thank you, Deputy Presiding Officer. First of all, I congratulate the petitioners who have led to the debate that we are having here today, which is a significant debate. It is the first time since I joined this Parliament that there will be a vote at the end of a discussion on the subject of organ donation, the previous debates in which I participated having been members' business occasions. Can I say straight away that, somewhat to my surprise, I find that I agreed with every word that the minister said in his speech in this debate? For Conservatives, this has always been a vote of conscience. I do not know whether that is the position of other parties, but we have said that when it comes to any legislative change, individual members will be able to come to their own view. However, all Conservative members will support the motion tonight, because we are of the view that, while some remain to be persuaded, I am not one of those who has any issue with the principle that we are discussing here today. We now have a fully worked-through legislative solution being implemented in Wales from December 2015, but we do not yet know whether that fully worked-through legislative solution will prove to be wholly robust or wholly effective. It seems to me that the minister's assessment that the best course of action is to remain sympathetic to what is being done and to wait and see and watch carefully and use that then, if it is successful, as a template for legislation in this Parliament. The one thing that I slightly regret already in the opening speeches is just the hint that we could suddenly find a politicisation of organ donation emerging in this Parliament. One of the things that was said by the Welsh Minister and the evidence that he gave to the Petitions Committee is that fundamental to its success was the broadest possible coalition of political support underpinning any legislative progress. I haven't spoken to my whips, but that doesn't matter. Would the member agree with me that this is one of those issues in which we would hope that the parties would have a free vote? I personally would, but that's not for me to take the position that the Conservatives will take. If I haven't had a concern on the issue of principle, I have had a concern about the issue of robustness. As the minister pointed out, Scotland has the highest level of voluntary registered donation of any of the nations in the United Kingdom, and 62 per cent of those people who subsequently are donors are not on that register. That has been done, I think, because there is a broad appreciation within Scottish public opinion about the desirability and the need for people to offer organs on death. However, there is a distinction in the minds of some about the voluntary nature of that donation or that donation being achieved on a voluntary basis in concert with the family who remain and the presumption that the state now owns your body at the point of death, which is a completely different proposition. My concern about robustness goes slightly further than it's this. That voluntary support for organ donation in Scotland has been hard-won, and I'm afraid there is a history of failure within the NHS, particularly in systems, for public confidence to be assured that the wishes of an individual will, in fact, subsequently be observed. Nothing would be more detrimental to voluntary organ donation in Scotland than were we to move to a system where, thereafter, it was demonstrated that the wishes of an individual were not respected either way. I'm afraid that we live in an environment where we know the media would make the widest possible hay with that particular event, and it could have a fundamentally detrimental effect on public opinion. I'm going to give way to Drew Smith, who sought to intervene first, and then I will take Rhoda Grant. I was very grateful to Jackson Carlaw, but would he not accept that, under the system that we have at the moment, people's wishes are not being respected? Simply carrying a card—I don't know whether we would say fortunate or unfortunate—but in the circumstances of your death that you were able to make the donation, you made a decision to carry that card and there is no guarantee that your wishes would be respected at all under the current system. I am sympathetic to the system that is being progressed in Wales, but there is a distinction between that and a legislative change under which the wishes of an individual are not respected. Frankly, the non-observance of that could have a far more detrimental effect on public opinion. Were it to be proven subsequently that somebody's organs were used when they had asked that they not be, I think that that could end up prejudicing very significantly public opinion. The point that Drew Smith made was the one that I was going to make, but can I be clear that there is an opt-out and a register that people can make their wishes known? There is the fall-back system of you tell your family you don't want to be a donor, so you've got basically belt and braces in the soft opt-out system. I accept both those points, which is why I would like to see the system that has been constructed for Wales. We took very considerable efforts from Mark Drakeford, which I think was very persuasive. It is why I would like to see that system tested in order that I can be assured that the very points that you make prove in practice to be substantiated in the event. Were that to be the case, then in the next Parliament, I think that there would be scope for the Government having considered the practice in Wales to consider whether or not to bring forward a legislative solution at that time. At this stage, we remain unpersuaded but sympathetic. We now move to open debate, five-minute speeches or thereby, Colin Angus McLeod, to be followed by Drew Smith. First, I would like to extend my thanks to Caroline Wilson, who brought this petition to the committee on behalf of The Evening Times and the Kidney Research UK Scotland. As we have heard from the convener, the petition calls on the Scottish Parliament to urge the Scottish Government to introduce an opt-out system of organisation to help to save more lives. Saving lives is the crux of this matter. Organ donation saves lives, therefore increasing the rate of donation will obviously allow us to save more lives. NHS blood and transplant report that, in Scotland, as of 8 April this year, 595 patients are waiting for a transplant. Last year, unfortunately, 34 people died in Scotland who are waiting for a transplant and more are taken off the waiting list as they become too ill to receive an organ. A Conservative estimate from the British Medical Association reports that around 70 per cent of people are willing to donate their organs after death, but Scotland has only 40 per cent of the population registered as organ donors, a figure that I'm both proud of and ashamed of. Proud because, for the last five years, the number of transplants has gone up, as the minister has referred to. The waiting list has got smaller and now Scotland has around 8 per cent more registered donors than the rest of the UK. Those improvements are due to the efforts of this Scottish Government and the regional health board in implementing the organ donation task force recommendations from the 2008 report. However, I am concerned because lives are still being lost unnecessarily because people who are willing to donate organs after their death simply never get round to making their views known. That results in relatives making a decision without knowing that the deceased was willing to donate. For this reason, it is essential that we look at ways in which the organ donation system can be improved further to reduce the number of avoidable deaths, particularly since 2008. The implementation of the organ donation task force recommendations have seen significant improvements in the infrastructure and increased donor rates. Now that that has reached fruition and the new systems and arrangements have become settled, we need to decide as a society and as a Parliament what the next steps should be. We have a very well-organised, well-funded and comprehensive infrastructure in place to facilitate organ donation, but clearly there is still a great deal of scope for improvement. The organ donation task force commissioned the University of York to undertake a systematic review of all relevant published data on an opt-out system of organ donation. Of the countries they looked at, they found that opt-out law or practice was associated with an increase of 21 to 30 per cent in the rate of donation following the introduction of an opt-out system. It would be misleading of me, however, not to inform Parliament that the study found a number of other factors also appear to be associated with improved organ donation rates such as transplant capacity, health expenditure per capita and public awareness. I believe that those areas have already been improved on and indeed the 2013 publication taking organ transplantation to 2020 follows up on the previous organ donation task force 2008 report and shifts focus to donor apacy. The new strategy builds on the achievement of an increase in donor registration and focuses on reducing high family refusal rates, which at 43 per cent is one of the highest in the western world. However, if Scotland was to move to an opt-out system of organ donation, we would not be starting from scratch. As well as the examples of the well-established opt-out systems in Spain, Austria, Portugal and Belgium that some have been referred to already this afternoon, the Scottish Government can follow the precedent set by the Welsh Assembly. The Welsh Act received royal consent on 10 September last year and it does, of course, introduce a soft-out system. The committee was pleased to take evidence from Mark Drakeford, Minister for Health and Social Services, during a very useful video link. I had hoped to cover the points raised during that session, however, my time is limited. I welcome the minister's assurance that he will follow progress in Wales with interest, although it will be at least two years before we will be able to judge whether it has been successful. I take on board the minister's view that the Scottish Government is not yet convinced of the benefits. However, I believe that it is clear that an opt-out system is an effective mechanism to increase the availability of organs for transplant and ultimately save the lives of people with end-stage organ failure who have no other treatment options available to them. I am of the opinion that an opt-out system of organ donation should be considered as part of the Scottish Government's broader strategy to improve donation rates. Under the system, individuals would have exactly the same choice as an opt-in system to donate or not to donate. I therefore look forward to the issue being debated in Parliament further, with a view to progress being made on the issue hopefully at some time in the not-too-distant future. I am grateful to have the opportunity to speak in the debate. I thank David Stewart and his colleagues on the Petitions Committee in their clerks for providing Parliament with his Jackson Carlaw, who says that it is a very welcome opportunity to consider those issues. I have previously said that I fully support a move to a soft opt-out organ donor register, and I support such legislation being brought forward as soon as possible. That is a view that I have put to the chamber before, in one that I have made known to the Petitions Committee during its consideration of the evening times petition, which was supported by more than 10,000 evening times readers. The campaign in which the evening times has run has been something that I have been privileged to have had a degree of involvement in. At this point, I want to put on record my thanks to Anne McTaggart for taking up this issue. I look forward to her contribution to this debate. Under the current system, we have no guarantee that our judgment in life will be respected in death. 90 per cent of Scots support organ donation, but, as Rhoda Grant rightly said, fewer than half of us carried a donor card.  However, the ultimate decision is taken by family members in the most difficult of circumstances, and there is no requirement whatsoever that the views of the potential donor are respected by the current system. I believe that a change from an opt-in to an opt-out register would help to support families who are unsure of what they should do. I know of families who have said that no one has gone on to regret the choice that they have made for their loved one. A change to an opt-out system would mean that those who wished to donate could have a greater degree of confidence that their wishes would be respected. Notwithstanding the views that the minister has expressed about the evidence, it is a position that is held by the British Heart Foundation, by Kidney Research and by the British Medical Association. It used to be the view of the cabinet secretary when he was in opposition that that could lead to a rise in the number of donations. For me, that is the crux of the issue, because I believe that it is a simple change that would save lives. It is a change that has already been supported by almost half of all MSPs across the chamber, across the parties, in terms of publicly giving their backing to the evening times campaign. That is before we have had any kind of detailed debate that might reassure those who might have initial concerns. That is a view that, in my case, I came to over time and I came to understand it as others, particularly my friend Richard Simpson, helped to bust the myths of so-called presumed consent. Whether there is an opt-in register or an opt-out register, the fundamental choice remains the same. It remains a choice for individuals. The choice to give remains something that we should celebrate and not take for granted. I have seen nothing in a change to an opt-out register that diminishes any of that. There are hundreds of people waiting on organ waiting lists. The opportunity that we have is not to remove the choice but to make the choice as easy as possible. The Parliament is capable of being bold from time to time. My party's front bench has committed our support, but that does not need to be a political issue if the Government is prepared to either bring forward a consultation itself or the issue of a free vote works both ways. If there is a member's bill, I hope that the Government would be extremely open to their back benchers giving support to that member's bill, given the breadth of support that has been put on the public record. I acknowledge that reassurances would be required, safeguards would be complex, new procedures would need to be detailed and a significant public information campaign would be essential before we could use any new register. When I spoke in this debate previously, that was in November 2012, I said that if we agreed on that date to do this, then change would still be years off and, in the meantime, more people would die. That is the reality of this. People have died in the time during which this petition has been considered. I absolutely recognise the progress that has been made, but I believe that without a clear timetable for reform more families will lose a loved one after months of waiting of dashed hopes, knowing that a donor could be out there somewhere who could help who would be willing to help, but the current system makes it harder for that match to happen. The Welsh Government has already done this, so when I asked the petitions committee to take evidence from them, I did it, because their experience in winning the public debate in Wales would be of great value in assisting Scotland to do the same, but I see absolutely no need to await a review of the legislation in Wales before we are prepared to act. I thought coming in here that the Government's objection was no longer in principle and it would simply be about timing, and I was concerned that that would be a delay that would cost lives. However, I have to say that I am disappointed by the comments from the minister about this afternoon. I think that it represents my departure from some of the previous words that we have had from Alex Neil and, indeed, from Nicola Sturgeon. I previously said that I was undecided on whether there should be an opt-out system of organ donation in Scotland. I suspect that this matter may ultimately come before the Health and Sport Committee where I sit as deputy convener. I was clear that I would have to scrutinise any legislation that may come before the committee and that that was a distinct advantage being undecided. In recent weeks I have come to the growing realisation that this may actually just have been a way of avoiding coming to a personal position on opt-out and then advocating that within our Scottish Parliament. In the meantime, I have looked on in admiration at Caroline Wilson's petition on behalf of the Evening Times and Kidney Research UK in relation to an opt-out system. I also had an unnerving feeling that I might not have been doing all that I can to help the constituents that I represent. However, what really impacted on me was a recent meeting that I had with the Cystic Fibrosus Trust. They too support an opt-out system for organ donation. However, that was not the reason for my meeting with them. It was in relation to their calls for changes to the lung allocation scheme for transplants. They are seeking a new national system as opposed to an original system of lung allocation for transplants. Indeed, I have corresponded with various public bodies in relation to this matter and there is clinical evidence in both sides of the debate and I understand that that is currently being reviewed. I think that that is important. There is strong evidence in both sides of the debate and there is not a clear route forward in any of this. As individuals, we have to balance up what is best for our constituents. However, what struck me about my meeting with the Cystic Fibrosus Trust was some other matters that they raised with me as part of a wider campaign that they have. That relates to organ donation. In particular, it was about the invidious choices that those listed living with Cystic Fibrosus have to make when desperately waiting for a transplant. For accuracy, let me quote directly from their briefing. They use the terminology extended criteria lungs. Support are extended criteria lungs. Those are, and I quote, lungs that fall out beside the traditional donor criteria set by the international society for heart and lung transplant. They may come from a donor who is over 55, have smoked or who have some mild lung abrasions. I should point out that those lungs are tested and cleaned before they are used. However, science is not perfect. There is a small amount of examples where recipients having had lungs from former smokers have gone on to develop lung cancer and have died relatively shortly afterwards. What a tragedy! Could you imagine the choice of a CF sufferer of having to decide between no organs or such lungs? I could not imagine what I would choose if I was in that situation. Would I wait for those perfect lungs to come available or would I take a punt in what I think was described as suboptimal organs earlier on in this debate? However, that was the story that Yvonne Hughes of the Cystic Fibrosus Trust brought home, the reality for many who are waiting for organs. Where does that leave me in relation to an opt-out system? Do I still have concerns with it? Absolutely, I do. The contradictions inside my head only get greater as this debate goes on, because I am quoting back some of the figures here. 93 per cent of people in Scotland say that they want organs to be used, but 43 per cent of families refuse organs, yet again 62 per cent of organs that are used come from people who did not carry an organ donor card. Without an opt-out system in the last five or six years, we have doubled the amount of organs available for transplants. No one in the chamber should say that this is easy, simplistic or straightforward, and it is most definitely not a party political issue with me. Christine Grahame, before she made an intervention, spoke about that I have not spoken to the whips on this. Why would she? We say what we like on this matter in this Parliament, and that is what I am doing. There is no need to speak to anyone other than to look at the facts and the evidence. What this debate has enabled me to do is to look seriously at this. Should I come to a position now on opt-out? I am still not quite there yet, but I have to say that I would have to find some strong compelling reasons not to have an opt-out system in the years ahead and, hopefully, in the not too distant future. I think that that is really important for me. It is important that we take this forward in this Parliament on the basis of consensus, so you have not quite got me yet in terms of opt-out. I have a number of concerns that I do not have time to put on the record here this afternoon, but I am left with the lasting impression that it is almost certainly the right thing to do. Actually, whether it makes a difference or not, because if only one life can be saved, surely it is worth moving to that opt-out system to save that life. I would just say to the chamber that, given slightly changed and indeed changing circumstances, I can now allow speeches of between five and six minutes. I will call Mary Scanlon to be followed by Christine Grahame. I am very pleased to speak in this debate in the absence of my colleague Dr Nanette Milne. In the debate secured by George Fawkes in January 2008, I stated that I did not support the concept of presumed consent, which, in my view, is a contradiction in terms. Presumed consent does not consent on the basis that consent means agreeing or giving or sent. That can only be freely given by an individual, and I strongly feel that donation of organs should be willingly given and not willingly taken. The organ donation is a matter of individual conscience and individual freedom and not a matter for the state. In that debate, I also used a quote given by a consultant at Aaron Brooks hospital who said, and I state, if as a doctor you have turned your thoughts to your patient being a donor when they are still living, that is a real conflict. That was six years ago, and I have to say that I still hold those views. However, I have carefully read the evidence to the Public Petitions Committee from Mark Drayford, Minister for Health and Social Services in the Welsh Government. I would like to commend the members, not only of the Petitions Committee, but also of the Welsh Assembly. In fact, across the political divide in that assembly, on the excellent consultation and work that they have done in moving to a soft opt-out system for organ donation. Like others, I am not saying that I will vote for this system if we are presented with this opportunity, but I certainly find many aspects of the soft opt-out system much more acceptable than the previous proposal of presumed consent. I would put on the record that I have no problem agreeing with the motion in front of us today. I like the idea that people can continue to opt in and put their names on the organ donor register, also that they can opt out or indeed they can choose to do nothing. As others have said, it is commendable in Scotland. We have the highest percentage of population registered for the organ donor register, which is currently 10 per cent above the UK average. It is also worth putting on record that we should commend the fact that the number of people donating their organs after death increased by 50 per cent between 2007-08 and 2012-13 and the significant increase in transplants. That coincides with the previous debate that we had in this Parliament. However, there is no doubt that more needs to be done given the UK transplant waiting list of over 7,000. It is also a concern that 43 per cent of families refuse to allow donation to go ahead, sometimes even overturning the recorded wishes of their loved ones. For all those reasons, although I am not sound up to the soft-optite system, I think that it is worthy of consideration. There are further issues to be worked through from the Petitions Committee evidence. One that struck me—I think that it was Chick Brody and Jackson Carlaw's questions at the committee—was the changing structure of many families. If someone has not opted out, there may not have been a discussion within the family of their commitment to donate organs. Secondly, if members of the family disagree about their understanding of the person's wishes, that could also be an issue. I appreciate that a person can be appointed to represent the views of the person. That is very helpful, but many people may not exercise that option. I have to say that it is certainly not something that I have ever discussed within my family. At the Petitions Committee, Jackson Carlaw rightly asked the question of who would arbitrate in the event of a person doing nothing at the point of donation. Who makes the ultimate decision for the transplant to proceed and also for confirmation that the family's view would prevail? The primacy of the appointed representative is very helpful. There is no doubt that considerable awareness raising and publicity is needed prior to any consideration of moving to this new system. I found a BMA briefing very helpful. I totally agree with it, but I thought the point that it was made about statutory guidance being needed surrounding any new legislation to provide clear guidance to professionals on how to deal with relatives' refusals. That has to be a very difficult thing, particularly what would be likely to cause distress to bereaved relatives and the process being carried out on an individual basis by trained professionals. The soft opt-out system sounds good, but it is not without some unintended consequences and challenges.  I think that the soft opt-out system addresses some of the concerns relating to presumed consent, and I will certainly welcome the input of a named representative and families. I am delighted that much progress has been made, and, like Jackson Carlaw, I am keen to follow the outcomes of the soft opt-out system in Wales, and I acknowledge my party's free vote on the issue. Thank you very much. I call Christine Grahame to be followed by Jim Hume. Thank you very much, Presiding Officer. The point that I was making to my colleague Bob Doris is that this should inevitably and must be a free vote across all the parties in this Parliament. I want to congratulate the petitioner on bringing this forward. I have spoken in previous debates on the issue and said that I fully support obtaining an increase in organisation through the opt-in system. I have opted in myself.  I also support an opt-out register, but I will refer to that later. I want to tackle some of the definitions that are used in this debate. We are talking of donation. If you are donating, this is willingly given.  If, and I will move on to whether it is deemed or presumed consent, there is silence, there cannot be donation. There cannot be refusal to donate, there cannot be willingness to donate. You do not know, but there is certainly not donation. When I challenged David Stewart about consent, whether it works as deemed consent or presumed consent, it is sophistry to say that there is a difference between deemed consent and presumed consent. That is a contradiction in terms because consent must be clearly and freely given and informed and the individual must have capacity. If you have silence, you cannot achieve any of those elements whatsoever and mistakes could be made, I think that I referred to earlier in the debate. I have got problems with donation and deemed consent. I do not have problems with two registers. Being on those registers should be mandatory on any family who are members there. They should be persuasive to family members of the wishes of the person when they had capacity and they gave consent or they withheld that consent being on either of those registers because it expressed their views clearly. I am going to pray in aid of that. A quotation I prayed in aid in 2008, if I may just go and I'll let you in if I've got a little bit of time. It's an important quotation because this is the words of a senior consultant surgeon at the Western Firmory who was there when traumatic people came in and her brain stem dead was imminent. This is what he said. It's unthinkable that a dead patient's organs would be taken without family agreement and hence discussion with the deceased family after a brain stem death will need to continue as before whether we have the two registers. It is vital that this discussion is informed by accurate knowledge of the patient's wishes expressed before death. This can only be guaranteed by a registration of patient's wishes whether for or against donation. In fairness to road, I want to just finish this point. Anything less than this form of balanced registration, it would be invalid as an indicator of the deceased's wishes and could not reasonably be used to inform the discussion with the deceased family which will need to take place even with a change in the law to presumed consent. My problem isn't with the two registers. My problem is that bit in the middle, this deemed or presumed consent. I think that you have to tread very, very carefully there. I think that it's absolutely right that we have an opt-out register. I think that it's right that we have an opt-in register. That makes the surgeon's job so much easier in discussing it with the family even as they do now. However, to have a surgeon have to say to somebody, I don't have your dead son or your dying son or daughter on either register. They're not on the opt-out register and they're not in the opt-in register but the law tells me that I can deem consent. I think that that makes that surgeon's job tougher. I think that it makes the conversation tougher. I think that we should leave that to the discretion that is exercised just now by surgeons, but by having the two other registers, you clearly have a better chance of persuading the family and, certainly, the family having some guidance, which is much needed in that circumstance. Rhoda, I think that I've got a minute. If you want, I'm happy, I've just got, I've finished. You have to finish by five and a half minutes. Would you want to come in now, Rhoda Grant? Rhoda Grant. Thank you for allowing the intervention. The current system allows families to make a decision on behalf of someone with no knowledge of whether or not they wish to consent or not. A soft-out system would allow people to either register their consent or their wish not to donate and would remove that onus from families. Currently, are you saying that the 63 per cent of donations made where nobody's on the register shouldn't be made now? I'm saying this very quickly. If you change the law when silence becomes something other than silence, becomes a deemed or presumed consent, you make that more difficult for the surgeon who has to inform the dying person's parents that that's the position in law. Two registers are a good idea, but not a presumption on silence. Thank you very much. I now call Jim Hume to be followed by Anne McTager to speeches of five and a half minutes maximum, please. Thanks, Presiding Officer. This is a debate of utmost importance. It's a matter of literally life and death. I think that it's appropriate that we debate it here today as a national conversation on organ donation has not been held since the human tissue act in 2006. I believe that Scotland needs to have an open and robust debate on this tricky issue of death because, as society, we too often postpone dealing with the difficult topics of palliative care and, in this case, organ donation until it's too late. I'd like to begin by praising the work of the Public Petitions Committee for considering Caroline Wilson's petition for taking evidence from the key stakeholders, and praise should be reserved, of course, for Caroline and the rest of the evening times team for leading an effective campaign that garnered over 18,000 signatures in support, ensuring that organ donation continues to occupy our thoughts. In the evidence submission to the Public Petitions Committee, the BMA said, a culture in which donation is discussed more openly and perceived as the norm would fit better with what most people claim to support. So the key question really is how do we arrive at a point where donation is the norm? Currently, there are 7,500 people waiting for an organ transplant in the UK, about 600 of those in Scotland. There are three people each day dying while on the transplant list waiting for an organ. However, the reality is that many whose life would benefit and be enhanced with a new organ will die each year before making it onto that waiting list. The demand for organs in Scotland is greater than what statistics such as Zs do tell us. We should acknowledge that progress has been made by this Government. The Organ Donation Task Force report six years ago has helped to oversee a 74 per cent increase in donations with 40 per cent of Scots now on their organ donor register. I believe that transitioning towards a soft opt-out system will help to close the deficit between the 50 per cent of Scots who are registered donors and the 90 per cent of Scots who support organ donation. I believe that the system means to include that lost 40 per cent of people who support organ donation but who, for various reasons, failed to become registered donors. Surveys have consistently shown that support for this system is in excess of 70 per cent of the population and countries that operate this model have roughly 25 per cent higher donation rates than informed consent countries. There are NHS boards that are reluctant to endorse the soft opt-out system NHS Tayside. For one, they are not alone highlighting their concerns that any assumption or presumption of patients' wishes would be detrimental to the doctor-patient relationship, and that could result in a reduction in levels of consent and authorization. Clearly, we would all wish to avoid any measure that would lead to an erosion in trust by doctors by patients, but I doubt that that would be the case. In the voice of Scotland doctors, the BMA is one of the most vocal advocates in favour of the soft opt-out system. They seem satisfied that there will not be a problem and therefore so am I. In preparation for this debate, I reviewed some of the evidence received by the committee from stakeholders and the contribution from NHS Fife concerned me in it. Dr Brian Montgomery explained that fear of failure by transplanting units across the UK is leading to too many healthy organs not being transplanted with several instances where such organs are subsequently successfully transplanted into European recipients. I wonder if today the minister can address Dr Montgomery's point and investigate whether that is common in Scotland and, if it is, try to ensure that healthy organs are not failing to be utilised. Similarly, we must tackle the practice of registered donors not having their organs utilised following the refusal to give consent by relatives. I understand that NHS Greater Glasgow and Clyde is as great as this as 15 per cent of donors. That relates to our society's reluctance to have the difficult conversations that need to take place, so we must encourage people to have those conversations. I would like to see the Scottish Government taking the lead in ensuring that that happens. The Government's recent donation and transplantation plan recommended a full public consultation on approaches to increasing organ donation in Scotland. I welcomed that. What I did not welcome was the failure to mention a soft opt-out as a potential measure in its talking points, instead referring to paying for the funerals of donors or giving priority to those on waiting lists who are registered donors. A soft opt-out, I believe, must be included in any consultation to allow the public to have their say. I believe that, with the proper safeguards and procedures in place, the vast majority of people would be satisfied with the soft opt-out model in Scotland. That is an effective means to drive up the number of denated organs being available to help save the lives of those people dying before they receive an organ or even a place on that waiting list. That has been demonstrated as working overseas, and I am confident that it could work here too. As a member of the Public Petitions Committee, I also would like to thank Kidney Research UK and Caroline Wilson, who is in the gallery of the evening times, for their tireless work in bringing this vitally important issue to the attention of the Scottish Parliament. Through the evidence presented to the committee by a wide range of individuals and organisations, I have been convinced that the introduction of a soft opt-out system of organ donation would be in the best interest of patients and would ultimately save lives. We know that most people in Scotland support the opt-out system of organ donation, yet the majority of the population have not yet chosen to register as an organ donor. A survey undertaken in early 2012 by the Scottish Government demonstrated that only 5 per cent of the population oppose organ donation in principle, and yet the United Kingdom continues to have one of the lowest organ donation rates in Europe. Enabling and encouraging those who support the transplantation of their organs after death to sign up to the register is a key priority, but I now believe that that is no longer enough when it comes to saving precious lives. In order to truly tackle the crippling shortage of organs in Scotland, we must adopt the Welsh model of soft opt-out system of organ donation. That will dramatically increase the number of organs available to the terminally ill, whilst allowing those who do not wish to donate the opportunity to remove their name from the register. Evidence presented to the committee by the Welsh Government highlighted some of the key reasons that the Welsh Assembly chose to pass the Human Transplantation Wales Act 2013. That legislation will come into force in December 2015, and it is expected that the move to an opt-out system will result in 15 more organ donors every year in Wales, donating an average of three organs each. That will result in as many as 45 lives being saved every 12 months as a direct result of changing the way that people can become donors. Under an opt-out system, individuals have exactly the same choice as an opt-in system to donate or not to donate. That proposal does not compromise the freedoms of an individual who objects to organ donation and wants to make the views known. In reality, that proposal would make it easier for those who do object to becoming organ donors to make their wishes clear. In an opt-out system, those who do not wish to be organ donors have the opportunity to make a positive declaration that they are opposed to transplantation of their organs. This is a decision that cannot be overturned by medical professionals after death. As you are aware, I agree with an opt-in and an opt-out register, but what about the silent people in the middle-watcher view about what should be done there? We are not proposing to remove anybody's right that, within that soft opt-out system, there is the right to either opt-in or opt-out. There is no silence. The family will still be consulted. There will be guidance and support throughout. If we can achieve reform, it is my ambition that organ donation will become the default position, which, with public support, will change cultural expectations in society. That represents a more positive view of becoming an organ donor, which should be encouraged in order to increase the number of people in Scotland who owe their lives to the incredible gift of organ donation. Following the evidence presented to me by a wide range of organisations and individuals, I am delighted to announce my intentions to bring forward a member's bill on this important subject, building on from the excellent work carried out by my colleague Drew Smith MSP. I intend to launch a consultation in the next coming weeks, which will gather responses from interested parties on reform of organ donation system in Scotland. I am hopeful that launching a member's bill on this subject will provide this Parliament with another opportunity to look at the compelling evidence in support of change and to scrutinise the powerful submissions made by the medical professionals, the third sector organisations and transplant patients in support of this important reform. I welcome further debate on this important issue, and I look forward to introducing the member's bill over the next few weeks—hopefully weeks and not months—on the introduction of a soft-out opt-out system. I aim to convince the minister and my fellow colleagues that a soft-out opt-out system is the way forward to changing the lives in Scotland. Many thanks. I am afraid that we now have to return to just over five minutes for the last two speakers. John Wilson will be followed by Margaret McCullough. I rise in this debate as a member of the Public Petitions Committee. Can I remind the members in this chamber what the motion before us actually says? Because there seems to be a debate about opt-in, opt-out, soft options and the rest of it. The motion actually says that the Parliament notes petition P1453 by Caroline Wilson on behalf of the Evening Times and Kidney Research UK Scotland, which calls for an opt-out system of organ donation in Scotland. It congratulates the petitioner on her efforts to raise awareness of organ donation and commends the issues raised in the petition and the evidence received by the committee to the Scottish Government for further consideration. It mentions the issue about an opt-out system, but it asks the Scottish Government to consider further. Based on the response from the minister today, it is quite clear that the Government is looking at the various options that are before us. Clearly, the minister outlined some concerns regarding the Spanish system and the Welsh system. We have to be clear in terms of a debate of this nature that we consider all the issues around us, particularly the issues regarding what happens in other countries and what happens elsewhere. We have to be aware that what we should be aiming to and striving to do is adopt the best system possible that takes the issue forward. For many people, it is a very emotive issue. I recall a constituent approaching me at my surgery one day to ask me to sign off on her consent form that she would donate her body to medical science. That constituent had to sit down when her family were together at Christmas to have that discussion with her family members, her children, to say that that was her express wishes that she wanted to donate her body to medical science. I think that it has been raised in this debate today already that many people find it difficult to talk to their family members, whether that be their parents or their children or whoever else in their family circle, about what their express options would be in relation to their death and what would happen with their organs when they died. The difficulty that we have in this debate is that, for many people, when they lose a loved one and are faced with the option of being asked whether or not those organs can be donated to help save someone else's life. In that moment, when they are being asked to make that decision, they are not in a mind to make those clear thought out decisions to make an informed choice. It is a very emotive time for many people when they have lost a loved one and for someone in the medical profession. We have had evidence in terms of what happens in Wales. Ultimately, in terms of the system that exists in Wales at the present moment, it is the medical professionals who make the final decision. Relatives are consulted, but the medical profession makes the final decision on whether or not the organs are used for transplant. The difficulty with that is that we could potentially lose the trust that exists between families and the medical profession who are trying to do their job within the hospitals and elsewhere. We have to be very careful. If Richard Simpson wants to make an intervention, then go ahead, Richard. I have wrestled with this since my original report to the health committee back in the first parliamentary session. The critical thing is that the member is absolutely right that making a positive decision about your deceased relative at that point in time is incredibly difficult. By changing the system to having a firm opt-out that you can register your right, you do not want to have the donation, it makes that central silent portion that Christine Graham referred to much easier. The question changes from making a positive decision to ask them, do you see any reason, do you know of any reason, do you know of the deceased's wishes that they might not want their organs to be donated? John Weltyn, you must do it at a conclusion, please.  That issue, not everybody has the capacity, at the present moment, to opt-out. We have to be very careful about what type of opt-out system we put in place to ensure that everyone has the opportunity to make that clear, distinct and informed choice. Margaret McCulloch, I can only give you five minutes. It has been six years since organ donation task force reported on ways to improve organ donation, and the progress that has been made in that time has been welcomed across the Parliament and across the medical profession, and quite the right so. Their findings have shaped policy, informed the work of government and the Scottish transplant group, and contributed to an increase in donation rates, which has exceeded expectations. As we have been hearing, many of the recommendations of the task force continue to be reflected in new strategy on taking organ transplantation to 2020. For all the progress that has been made in recent years, over 600 patients in Scotland are still waiting for a transplant, and the sad truth of the matter, as too many families out there know from their own tragic experiences, is that many of those people will die waiting. We have to ask ourselves, as a Parliament and as a society, whether we are all doing all we possibly can. As the BMA put in the evidence of the Public Petitions Committee on this topic last year, now that we have a well-organised, well-funded, comprehensive infrastructure in place, is that enough? Can we say that we have done all we can, or should we now look to go further and building this progress by shifting our attention to new ways of increasing the number of donors and the number of lives saved? I believe that there is scope to do more, and I believe that there is merit in a soft-out option system of organ donation registration, like the system now used in Wales. Let me explain why. We know that there is widespread support across Scotland and across the UK for organ donation. Figures quoted in evidence to the committee put the figure at 90 per cent. However, we still face a huge challenge in translating majority support for organ donation into better levels of donor registration. If organ donation is such a widely supported concept, then what is wrong with normalising the practice is a practice that can save lives. For us, a country that has already improved our infrastructure and our capacity to transport organs, surely the next step is to look at new ways of increasing donation rates through legislative and cultural change. Surely the next step is to give serious consideration to the soft-out option. It is not just a matter of changing the law and moving towards a position of presumed consent. It is also about changing attitudes and creating a culture of openness and understanding in which we can more readily talk about what we want to happen to our bodies if the unthinkable should occur. Of course, there should be rigorous safeguards to make sure that liberty and choice are protected. Presum consent does not mean doing away with the choice, and I do not accept that it curtailes liberty. Choice must remain as safeguards would have to be put in place. Families should be consulted even when their loved ones have failed to opt out to establish whether they are aware of any objections and whether proceeding with organ donation would cause them distress. We would have to step up in on-going campaigns to educate people about organ donation and encourage people to talk to their families about their wishes. Finally, the University of York was commissioned by the organ donation task force to look at the experience of countries that applied the principle of presumed consent to donor registration. It found that, while there were various factors that could be affecting donation rates, the opt-out system was associated with an increase. The task force decided in 2008 not to recommend a soft-out option, but it did suggest revisiting the issue at a later date. That time has now come, so let's take this opportunity today to put a soft option out back on the agenda. Let's take the next step to improve donation rates and ultimately save lives, and let's opt for something better and give this petition our time, our consideration and our support. Many thanks. We now turn to closing speeches, and I call on Jackson Carlaw up to six minutes please. Thank you, Deputy Presiding Officer. I'd like to begin by singling out the contribution of Bob Doris, who's sadly not in his place at the moment, for the summation and attention he gave to the issues around cystic fibrosis, which I did myself crystallise in a motion 10 days ago to which I hope he'll lend his support. In my opening speech, I concentrated very much on the potential reputational damage issues, and I'd liken my summation to give voice to Mark Drakeford, the Welsh Minister, who responded to the concerns that I raised. I am going to quote from what he said. Those are really important points. The issue of reputational damage to the system were organ donation to go ahead in circumstances where the donor clearly did not wish it to happen, or vice versa, has preoccupied us during the process of the bill. I say to people who ask me in Wales that opting out will be absolutely as easy as opting in. It will not be made more difficult. We will make sure that anybody who wants to opt out can do so as easily as anybody who wants to opt in can do it. People will be able to opt out at general practitioner surgeries by visiting the internet site and so on. It will be very straightforward. The safeguard in our system comes through the role of the family. Donation cannot go ahead without the involvement of the family. As you suggested, someone might have opted in on the register many years previously, but might subsequently have changed their mind and come to a different view. If the family knows and is able to tell the clinical team that, even though the individual is on the register as being in favour of organ donation, their views have changed and they would not wish to be a donor, the family's view would prevail. The safeguard comes through having the discussion at the point where a decision has to be made. We will not rely simply and solely on the register, even though we are confident that the register itself will be friendly to users and as accurate as it can be. Where people have no family, if they have appointed a representative, the donation will go ahead, but if somebody dies and no family member or representative can be found, the donation will not go ahead. We have had debate about that because somebody with no family members might have opted in and put their name in the register, but there are issues other than consent. For example, the clinical team will have to pursue with the family issues of medical history and whether the person is in a proper clinical condition to be a donor. From the clinical evidence, we know that those circumstances will be rare, but to protect the integrity of the system, our decision has been that if a person has no family and no representative, the donation will not proceed. I want to say to Drew Smith, who I have very high regard for and who I thought looked rather crushed and I felt slightly affected by the sense of disappointment emanating at him from the position that I articulated and the minister articulated, that I believe that there is the prospect of the widest possible political consensus around this issue in the chamber, but I do not myself believe that it would be wise to push ahead when we have evolved. I think that the Welsh have got right in the legislation that they are promoting without, and I do not think that it is such a huge window, without giving that legislation the opportunity to prove itself, which I think it will do in very early course, because any of the difficulties that are contained within it, I think, will materialise initially quite quickly, and that would give the opportunity for any legislation that subsequently came forward in Scotland the chance to reflect that. It seems to me—yes, I will. I want to address the issue that Jackson Caller addressed immediately beforehand, which is surely to suggest that one of the things that we should be encouraging, and I recognise that there are other parts of this debate, is that members of the public have the card in their pocket, so that if they get run over by a bus, there is actually no dispute about it. If we get encouraged people, one to sign up and two to carry it, much of the attack debate would go away. I think that I would say to Mr Don, we have been pursuing that course and Scotland is more successful than any other of the nations within the United Kingdom, and I think that it is a remarkable tribute that we are at that point, but I accept that there may be, out of all this, the opportunity for far more lives to be saved. I just wish to make an appeal, because the sense of this coming to me this afternoon is something that has left me quite deeply troubled, that any progression of this issue should enjoy the widest possible political consensus in this Parliament. I think that political consensus can be achieved. There are members, Mary Scanlon and others, who are not yet quite there, and I think that it would be wrong to push us there on such an important issue when we could actually all get there without being moved to a point where we end up in a political confrontation over something so terribly important, because I think that that would fundamentally undermine public confidence. I am grateful to Jackson Carlaw, but would he not agree with me that what I certainly would have hoped to come out of this debate would be for the Scottish Government to indicate a level of consideration and consultation in this issue that goes better than saying that we will wait to see what another country does before we put the case for... Jackson Carlaw and your final minister. I think that that is a slightly ungenerous characterisation of what the minister was suggesting. I find myself very much in agreement with him on all of this. In December 1, 2015, in all practical senses, I think that we will have an opportunity early in the next Parliament to have had an assessment of what the implications of that legislation in Wales have been. If they have proved to have made a significant advance, then it can come to this Parliament. I say again that Conservatives will have a free vote in the issue whenever it does come before the Parliament, but I am one of those who is moved to support it, but wants to support it knowing that we will carry public confidence with us and confidence that the public will see this Parliament united in that move, because I do believe that, if it were not, that could have a profound effect on the reputation of organ donation in Scotland, and that, I think, would be the last thing any of us would wish to see. Many thanks and I call in Neil Findlay, maximum six minutes please. Thanks, Presiding Officer. This has been a very welcome and important debate and indeed the petition. It is the type of issue that this Parliament, I think, has the duty to discuss, consider and conformer with recommendations for improvement or change, because that gets right to the heart of one of the most important issues of all, and that is the ability of politics and politicians to take decisions not only to change lives but, as Jim Hume said, to help to sustain and extend life itself. That is what is at stake here, could not be more important. We have heard from Rhoda Grant and Angus MacDonald that around 600 people in Scotland are waiting for some form of organ donation. 600 people are affected by debilitating conditions. 600 families whose lives are in hold are waiting for the phone to ring, but for too many of them, unfortunately, the phone never does. Yet we have the power to do something about that if we have the political will to act. Presiding Officer, organ and other forms of transplantation have always been at the cutting edge of medical innovation and development. We have witnessed some of the most astonishing advances in medical science from the very first skin grafts in the 19th century through to recent years. We are unbelievably seeing whole-face transplantation for a non-scientist and non-medic. Those things to me are medical miracles that have changed and sustained the lives of heart patients, kidney patients, lung disease sufferers and liver patients throughout the world, yet how many more people could we help if we had a better system that allowed more organs to be donated and transplanted, a system that allows those to opt out and not opt in, a system that could provide many more donors and donations. I listened carefully to the Conservative representatives today, in particular Jackson Carlaw appealing for this not to be political. While he was not party political, he was indeed very ideological in his objections that he raised in the sort of spectre of the state against the freedom of the individual as one of his great concerns. I think that we can dispel that as we debate this further. For one, it would never say that this is a simple issue, but other countries successfully operate such a system, and I believe so could and should we. Of course, it would have to be done with the buy-in from the general public. They are the future donors. We need them to support this move. We need them to be full and active partners in any new system, but it can be done. A major public education programme could change things, could be highly effective. As Dave Stewart and Margaret McCulloch mentioned, we can put in place safeguards and options for people who have concerns. The current system sees a third of people registering. Of course, some people have their very own particular and often very personal reasons for not registering, but for many people it is simply something that they have just never got round to. I probably suspect that a number of us are in that category. An opt-out system could change things dramatically, providing many more life-saving and life-changing organs for the nation, but also raising the debate and breaking down some of the taboos about death and end-of-life care. I agree with some of the people who are not getting round to registering, but a knocked-out system would be the exact same principle. It is certain that communities that are less likely to register to vote or vote would also be least likely to opt-out, and that would change the culture of campaigns that would have to be a public information campaign that would encourage people to opt-out if they wished. That would be a very different dynamic that we would have to grapple with. Neil Findlay. I could say absolutely that those are the challenges that we face in this, and if we are serious about it then those are the challenges that we should face up to. I think that it would be good for the NHS to raise awareness of health issues, improve training for staff and, in the long run, save much-needed resources, but most of all it would provide extra years of quality of life for those people affected. We see that in countries that have adopted the soft-opt-out system, the number of organs available has increased. In Norway, the system provides a high level of donation, but in neighbouring countries, with mandated systems, significantly lower figures emerge. I accept, as the British Heart Foundation says, that there are other issues at play, the level and quality of infrastructure, supporting any system, some social norms and practices, and some religious interpretations. I absolutely respect the concerns of Jackson Carlaw from the minister and others, but, like Drew Smith, I think that many of those concerns can be overcome. Several mentioned the Welsh system, which is a Welsh Assembly that is leading on the matter. It has had that informed public debate and has secured public support. For people who need a transplantation, life is very tough, but the thought of healthy life-changing organs not being available can only further exacerbate their feelings of desperation. This Parliament has the chance to change and extend lives. It is my judgment that there would be a majority in this Parliament for such change. I look forward to Anne McTaggart bringing forward her member's bill on this. It is difficult and a very emotive issue, but that is what we are elected to this Parliament to debate and to take decisions over. I think that we should do the job that we are elected to do. I have listened to the views from across the chamber with three interests this afternoon. It is an issue that I recognise that is very emotive and carries a wide range of differing views. However, I say that I want to strike a note of caution in this matter. I think that there is a danger that this matter could start to become politically polarised in the way in which some of those issues are being presented. I think that it has got to be recognised that there are views right across this chamber for and against soft opt-out opt-in, whichever mechanism you wish to bring forward. However, it is important that we all stick together in terms of the shared agenda of looking to increase organ donations in Scotland and finding the best way in which we can go about trying to achieve that. The approach that we have taken over the past five years has reached very significant improvement, better than any other part of the United Kingdom, and that should not be forgotten. The approach that we are taking to date is in order to build on that progress yet further. It is on that point that I want to say to both Rhoda Grant and also to Drew Smith that there has been no change in the Scottish Government's position in this matter. Nicola Sturgeon has previously given her own personal view in this matter. Her view remains the same as is the Cabinet Secretary for Health and Sport now. Her personal view remains the same. However, the Scottish Government has said previously that it was not persuaded, and the position that we have taken now is that we remain, we are not persuaded as yet, a