Health Committee supports introduction of Health Board elections


The Health Committee has today come down in favour of direct elections to Scotland’s area health boards in its report on the Health Board Elections (Scotland) Bill.

View the committee report.

Concluding that the status quo is not an option, the committee supports the general principle of Bill Butler MSP’s member’s bill which calls for the introduction of local elections to Scotland’s 14 area NHS boards to improve public representation.

While supporting the principle of direct elections, the report calls for further consideration to be given to the proportion of members that are directly elected and to which process should be employed to ensure the candidates selected are geographically and socially representative.

Committee convener, Roseanna Cunningham said:

"During evidence sessions, the committee heard repeatedly of dissatisfaction with the current consultation processes and, in particular, the number of consultation exercises which appear to have pre-determined outcomes. We have considerable sympathy with these views and agree that the status quo is not an option and that change is required.

"Although the committee supports the principle of direct elections to health boards, it is not convinced the bill outlines the best way forward and suggests three areas where further consideration is required.”

The committee report lists three areas of concern which should be addressed:

  • the proposed size of the electoral ward may result in undemocratic geographical representation and the committee believes it would be fairer to sub-divide the board areas into a number of more representative electoral wards;

  • the committee recognises that there is a debate to be had on the proportion of board members to be directly elected;

  • the bill does little to promote and encourage fair and equitable public representation with the absence of any remuneration, compensation for loss of earnings or expenses incurred creating discrimination against people on low incomes.

Roseanna Cunningham added:

"The absence of any remuneration for elected members is likely to discriminate against people with low incomes and will favour candidates who are retired or are well off.

"The committee believes that directly elected members should receive payment. This could be by annual remuneration comparable to that already paid to non-executive board members, or through compensation for loss of earning and/or expenses incurred.

"We believe that change must be made to plug the current democratic deficit but in doing so we must ensure that as many people as possible have the opportunity to represent or select a representative of their choice.”


  • The Health Board Elections ( Scotland) Bill was introduced by Bill Butler MSP on 31 March 2006.

  • The bill aims to resolve dissatisfaction with the way Health Boards consult and engage with the public on the provision of local services by introducing local elections for membership to the 14 area National Health Service (NHS) boards in Scotland. It excludes Special Health Boards which generally have a nationwide or specialist function. The proposed method of election is a postal ballot for a ‘first past the post’ electoral system in the context of a multi-member constituency for a fixed four year term starting in May 2008, with all the costs being met by NHS boards.

  • The bill suggests that 50 percent, plus a maximum of two representatives, would be directly elected by the public, thereby forming a democratically elected majority. Board Chairs would still be appointed by Ministers who would also continue to be responsible for the appointment of non-executive members.

  • With the exception of Liberal Democrat MSP, Euan Robson, who opposed the bill, the majority of the committee were either in favour of or neutral to the proposal.

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