Equality Impact Assessment (EQIA) - The Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill – Provision of Communication Equipment

Title of Policy	EQIA - Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill - Provision of Communication Equipment
Summary of aims and desired outcomes of Policy	It is the intention of the Scottish Government that every adult and child who has lost their voice or has difficulty speaking are provided a statutory right to communication equipment and support when required. The broad policy aims for the provision of communication equipment element of this Bill are: To ensure that individuals who require or use Alternative and Augmentative Communication (AAC) are provided with the necessary and most appropriate equipment to meet all reasonable requirements and; Support and assistance is provided to allow the individual to take advantage of the equipment and be able use it properly.
Directorate: Division: team	Directorate for Population Health Improvement: Care Support and Rights Division: Patient Support and Participation Team

Executive summary

1. The public sector equality duty requires the Scottish Government to assess the impact of applying a proposed new or revised policy or practice. It is a legislative requirement. More importantly, most policies impact on people. Not all people are the same and policies should reflect that different people have different needs. The equality legislation covers the protected characteristics of: disability, sex, age, gender reassignment, sexual orientation, race, religion and belief, marriage and civil partnership and pregnancy and maternity.

2. This Equality Impact Assessment (EQIA) has considered the potential impacts of the Bill on each of the protected charactersistics. The provisions and how they impact on adults and children across the protected characteristics are set out under Key Findings.

3. As this Bill is intended to be of a positive benefit to Scotland's population, regardless of whether they fall into one or more of the protected groups, the EQIA has not identified any Bill provisions that would have an adverse effect on such groups.

4. The evidence and data gathered has been analysed and indicates that overall the provisions in the Bill will have a positive impact on the population of Scotland, as well as on equality issues. As a result of this, it is not considered that any changes be made to the provisions as a result of this assessment.

5. The EQIA however, has identified that there are opportunities to improve data sources in order to increase our understanding of adults and children who require or use AAC who belong to particular equality groups and their experiences of this service. This will be developed through the operational improvement work that is being taken forward and will be used to inform any further policy development in the future.

Background

Policy Aims

6. A Right to Speak, the Government's strategy for provision of Augmentative and Alternative Communication (AAC), was launched in April 2012 in a response to a campaign in 2007 led by the Royal College of Speech and Language Therapists (RCSLT). The strategy set out a vision for a Scotland where people who use AAC are fully included in society.

7. The strategy was supported by new funding of £4m over three years, 2012-2015. This funding was made available to Health Boards and NHS Education for Scotland (NES) to develop services and support and purchase equipment.

8. The Now Hear Me report which was produced at the end of the Right to Speak implementation period concluded that whilst significant progress had been made, there was still work to be carried out before the aspirations set out in 'A Right to Speak' report were fully realised.

9. The Programme for Government 2015-2016 announced in September 2015 that the Scottish Government recognised that access to voice equipment was vital to children and adults who have lost their voice or have difficulty speaking and that it would, therefore, bring forward an amendment to the Health (Tobacco, Nicotine etc. and Care) (Scotland) Bill to provide a statutory right to voice equipment when required.

10. The amendment will place a duty on Scottish Ministers to provide or secure the provision of communication equipment and in addition for Ministers to be under a duty to provide support or assistance to allow the recipient to take advantage of the equipment and use it properly. The provision is to be made to such extent as Ministers consider necessary to meet all reasonable requirements of the recipient of the equipment.

11. Whilst the duty is being placed on Scottish Ministers in the legislation; there is provision within the National Health Service (Scotland) Act 1978 (the 1978 Act) which allows the Ministers' functions under the act (like this new duty) to be delivered by Health Boards.

12. Ministers have powers already in the 1978 Act to give directions to Health Boards about the way that they carry out their duties and functions which Health Boards must follow. Directions in connection with the new duty are planned in the future. These will support the operational improvement work required in these services.

13. The broad policy aims for the provision of communication equipment element of this Bill are:

• To ensure that individuals who require or use Alternative and Augmentative Communication (AAC) are provided with the necessary and most appropriate equipment to meet all reasonable requirements and;
• Support and assistance is provided to allow the individual to take advantage of the equipment and be able use it properly enabling them to meet their needs.

14. Scottish Government recognise that many Scottish Health Boards already provide a communication equipment service and we are determined to build on that existing good practice, to raise the profile of AAC by driving further performance improvements and promoting greater consistency, ensuring AAC remains a board priority.

15. The amendment will contribute to three of the Scottish Government's five National Objectives that underpin its core purpose: Wealthier and Fairer; Healthier and; Smarter Scotland.

It will also contribute to nine of the sixteen national outcomes

• We live longer, healthier lives.
• Our public services are high quality, continually improving, efficient and responsive to local people's needs.
• We have improved the life chances for children, young people and families at risk.
• We are better educated, more skilled and more successful, renowned for our research and innovation.
• Our young people are successful learners, confident individuals, effective contributors and responsible citizens.
• Our children have the best start in life and are ready to succeed.
• Our people are able to maintain their independence as they get older and are able to access appropriate support when they need it.
• We have tackled the significant inequalities in Scottish society.
• We take pride in a strong, fair and inclusive national identity.

16. The express purpose of the Scottish Government is to focus government and public services on creating a more successful country, with opportunities for all of Scotland to flourish.

17. Scottish Government recognises that AAC has the potential to enhance the lives of many individuals with severe communication impairments and that access to communication equipment is vital to children and adults who have lost their voice or have difficulty speaking.

The Scope of the EQIA

14. It was clear that an EQIA would be required from the onset of this policy due to the positive impact it will have on people who have lost their voice or have difficulty speaking.

15. Due to the challenging timescales between the Programme for Government announcement and the legislative journey through Parliament, Scottish Government were unable to carry out a formal consultation exercise. They did however, consult with key stakeholders on whether they felt there were any equality issues that they felt may arise/have arisen during the life of this service and if so, how these could be addressed.

Key Findings

15. The EQIA evidenced that the main protected characteristics that this policy affects are age and disability. The breadth of the amendment is deliberate to provide flexibility to determine who might receive communication equipment and support and what type of equipment and support might be provided thereby eliminating discrimination, promoting equality of opportunity and fostering good relations, resulting in equal access for all to this service.

16. In relation to the other protected characteristics such as; sex, race, religion or belief, pregnancy and maternity, gender reassignment, sexual orientation and marriage and civil partnership there was no evidence to suggest any sort of discrimination towards these groups.

Recommendations and Conclusion

17. No negative impacts on any one or more protected groups has been identified, however it has been identified that we need to know more about individuals who use or may require AAC in the majority of the protected groups. This will form part of the operational improvement work that is being taken forward.

18. The EQIA demonstrated there were no specific changes required to the amendment. As the amendment moved through the parliamentary process, co-production and collaboration with key stakeholders meant that the equality impact was always at the forefront of the development.

19. The EQIA has also evidenced that we are delivering on the Government's purpose. The overall outcome of the introduction of the amendment has been positive, and it will have a positive impact on all people of Scotland who have lost their voice or have difficulty speaking, for example; improved mental wellbeing, better education/employment opportunities and improved quality of life for individuals, families and communities.