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MINUTES OF PROCEEDINGS OF THE HEALTH, SOCIAL SERVICES AND PUBLIC SAFETY COMMITTEE AT 2:00 PM ON WEDNESDAY, 18 SEPTEMBER 2002 IN ROOM 135, PARLIAMENT BUILDINGS
Dr Hendron took the Chair at 2:00 pm.
The Chairman reported briefly on the successful dinner last evening attended by Committee members and representatives of the BMA (Northern Ireland) in Parliament Buildings. The main items discussed included the implementation of the Local Health and Social Care Groups, hospital waiting lists, shortages of health service staff, and the EU Directive in respect of junior doctors' hours, which is due to come into effect in 2004.
The minutes of the meeting of 11 September 2002 were agreed.
There were no matters arising.
Ms McWilliams joined the meeting at 2.20pm.
i. Fire Services (Appointment and Promotion) (Amendment) Regulations (Northern Ireland) 2002
The Chairman explained the latest position in relation to the above Statutory Rule, which sets out the criteria for the appointment of the Chief Fire Officer for Northern Ireland and is intended to widen the pool of potential qualified candidates for the post. Following the Committee meeting of 11 September 2002, the Clerk had written to the Department to request clarification of the meaning of "equivalent qualifications" and details of the criteria under which certain public sector posts are exempted from the EC freedom of movement legislation.
A written response had been received, which explained that the Department had laid the Regulations on 16 September 2002, to ensure that the post of Chief Fire Officer was filled as soon as possible. This meant that the Committee would not have the opportunity to suggest any amendments to the draft regulations. The letter gave further information on the requisite experience and qualifications for the post and confirmed that judgements on the equivalence of posts would rest with the Northern Ireland Fire Authority Board, on advice from HM Inspector of Fire Services.
Mr McMahon reiterated the Minister's strong desire for the post of Chief Fire Officer to be filled as soon as possible by the best candidate. The Department's legal services had confirmed that it would not be advisable to prescribe in law the equivalence of qualifications and experience in respect of the requirements for the post of Chief Fire Officer, as this would result in future sporadic amendments to the legislation. Mr McMahon emphasized the Department's confidence that the new arrangements would not dilute the standards currently required for the post of Chief Fire Officer in terms of the level of experience and type of qualification.
Mr Berry advised that he was not content that the reference to "equivalent qualification and experience" in the amendment to the regulation would require applicants from outside the UK to match the same experience and qualifications of local candidates. He felt that the amendment called into question the capabilities of local senior fire officers, and he voiced concern at the lack of consultation on the proposed changes. Rev Robert Coulter stated that the new provision under which equivalence must apply to both experience and qualifications was still somewhat ambiguous. He was not satisfied that direct comparisons could be properly be made between applications from UK and non-UK nationals.
Ms Armitage emphasized that her support for the statutory rule was contingent on there being the facility to appeal to the Equality Commission by an unsuccessful candidate.
The Chairman emphasized that the most important point was that the person appointed to the position of Chief Fire Officer should be completely competent and enjoy the full confidence of the Fire Brigade staff. He also underlined the importance of the Committee's having due regard to the principle of equal opportunities and the freedom of movement for workers across the EU when considering the amendment to the legislation.
Question put, That the Health, Social Services and Public Safety Committee has considered:
Fire Services (Appointment and Promotion) (Amendment) Regulations (Northern Ireland) 2002
and, subject to the Examiner of Statutory Rules being satisfied as to its technical effectiveness, has no objection to the Rule.
The Committee divided: Ayes 6, Noes 2
Ayes: Dr Hendron, Ms Armitage, Mrs Courtney, Mr Kelly, Ms McWilliams, Ms Ramsey
Noes: Mr Berry, Rev R Coulter
Question accordingly agreed to.
ii. The Adoption (Hague Convention) Regulations (Northern Ireland) 2002
Agreed: The Health, Social Services and Public Safety Committee is content with the Department's proposals for The Adoption (Hague Convention) Regulations (Northern Ireland) 2002.
Departmental Officials: Mr Don Hill, Deputy Secretary
Mr Andrew Hamilton, Director of Finance
Mrs Karen Campbell
Mr Hill gave a brief presentation on the above review, which was commissioned by the Executive and jointly chaired by the Department of Finance and Personnel and OFMDFM. The reviews (six across the departments) were therefore independent of each Department. Mr Hill underlined the critical nature of the document as an objective assessment of the scale of underfunding and of the effectiveness of the service. The main issue of importance in relation to the reviews was to test whether the Barnett Formula, which is population based, was still the best formula for distribution of UK resources. The terms of reference are directly related to a relative needs exercise. Key points arising from the Needs and Effectiveness Evaluation are as follows:
Factors that affect relative need for HPSS resources
Result of Needs Assessment
Implications of spending gap
Areas that need to be addressed
Mr Hill advised that the existing arrangements for auditing are subject to change under the Audit and Accountability Bill. The Comptroller and Auditor General will have direct responsibility for audit of the entire health service under the new arrangements.
In response to a query by Rev Robert Coulter on the reduced beds capacity in the face of increased service demands, Mr Hamilton advised that this was a consequence of the health service being obliged to make efficiency savings over a number of years in order to meet financial targets. Some £195m had been extracted from the HPSS by annual 1%-2% cuts in the baseline between 1983 and 1996/97. Prior to that time, Northern Ireland had the lowest waiting lists in the UK. It is now recognised that this was a short-term measure that was not in the best interests of patients. As a result of the recent RRI initiative, some additional 100 beds are to be made available across three acute hospital sites. Additional funding for waiting lists will provide added protected elective capacity.
Mr Berry voiced concern at the plight faced by the private residential homes sector and asked what was being done to support that sector. Mr Hamilton undertook to provide the Committee with the numbers of homes that have withdrawn. He acknowledged that private residential homes are essential to health and social care services, which requires sufficient resources to enable the homes to meet the required standards. A programme of phased funding increases has been developed to achieve this aim.
Mr Kelly asked whether there was a solid foundation in current funding levels for building up the health care system. Mr Hill explained that, unless there was a sustained increase in resources, the current difficulties would continue. He advised that the plans and strategies were in place but needed to be supported by a major investment of resources. He pointed to the objective assessment that Northern Ireland was being funded by up to £200m less than England. Total expenditure per head on health is 45% of the total spend in England, in Scotland 41%, Wales 43%, but in Northern Ireland the figure is just 35%.
Ms McWilliams asked how the Department was ensuring that collaboration was taking place among Trusts to ensure that hospital capacity is optimised across the region. She expressed concern that, for example, tonsillectomy services were being underused in one hospital while the same services in a neighbouring hospital were overstretched. She asked what was being done to compare core financial costs across Trusts.
Mr Hamilton confirmed that the Department intended to develop new systems to support management and decision-making, as well as dealing with core financial issues. He advised that the Department has embarked on an initiative that will provide a detailed comparison of costs of Trusts. The results of the surgical specialities have been published on the Internet. The aim is to have all hospital specialities costed in this way by 2004. The figures show that Northern Ireland's average costs are broadly comparable with GB. This data will give a focus by setting costs alongside activity figures for hospitals. The Committee will receive updates on performance by way of a Departmental monitoring report. Mr Hill undertook to provide details of collaborative work being taken among HSS Boards to tackle "winter pressures".
The Trusts are now managing their operations under the new strict financial regime, which means that the historical deficits will no longer exist. In terms of an audit trail, clear links exist between additional resources and the associated outputs.
Agreed: The Clerk will write to OFMDFM and the Department of Finance and Personnel, as joint sponsors of the Needs and Effectiveness Evaluation Review, to ascertain what steps they intend to take as a consequence of the clear findings in relation to relative health care needs assessment and the widening funding gap between Northern Ireland and GB.
The Clerk will also write to the Department to request details of the recommendations for seven projects to be taken forward in the next stage of the Review of Community Care.
6. Protection of Children and Vulnerable Adults Bill: Oral Evidence
Probation Board for Northern Ireland
Witnesses: Mr Brian McGaughey
Mr Paul Doran
Ms Val Owens
The witnesses gave a brief presentation on the relevance and importance of the Bill to the Probation Board for Northern Ireland. The organisation listed five main issues arising from the Bill, which are summarised as follows:
Ms McWilliams recommended that consideration be given to suggesting an amendment to clauses 21 and 22 (on disqualifications) by way of strengthening the provision of the court to make a disqualification order.
The entire proceedings are recorded separately in verbatim minutes of evidence.
SSAFA Forces Help
Witness: Mrs Maggie Smith
Mrs Smith gave a brief presentation on the perceived gaps in the provisions of the Bill in relation to the arrangements for carrying out background checks on persons serving with the Armed Forces and their families.
Agreed: The Clerk will write to invite the Police Service of Northern Ireland Superintendent who is responsible for child abuse investigation to request evidence in relation to the implications of the extension of Part V of the Police Act 1997 to Northern Ireland. The Clerk will also write to the Three Bureaux Implementation Group for details of its co-ordinating work on the protection of children and vulnerable adults.
i. The Clerk reminded members of the visit to Belfast City Hospital Trust at 12.30pm on Thursday, 19 September 2002 for an update on progress on the Cancer Centre.
ii. A copy of the Health and Personal Social Services (Quality, improvement and Regulation) Bill will issue to members. The Clerk will make provision for the Committee Stage of the Bill in the future work programme.
iii. The Clerk advised that a thank-you letter had been written to the Director of Public Health of the Southern HSS Board, Dr Anne Marie Telford, following the Assistant Clerk's attendance at the recent meeting of the Board's Managing Acute Pressures Group. Documentation had been issued to members on the work of the Group, recent initiatives and the obstacles to improvement, which the Committee found valuable.
Agreed: The Clerk will write to invite Dr Telford and other representatives of the Group to make a presentation to the Committee on its work and to provide an update on the effectiveness of its initiatives over the winter period. This meeting will be scheduled for early in the new year.
iv. Agreed: As part of its scrutiny of the Budget and Programme for Government, the Committee will focus on the resource allocation for community care and examine what services were delivered in the last year in this area. This will include a comparison of the variation in rates set for residential care homes in the statutory and private sector.
v. The Clerk reminded members of the confidential nature of part of a written submission received from a parent on the Protection of Children and Vulnerable Adults Bill.
vi. The Chairman reminded members that the next Committee meeting would take place at 10.00am on Tuesday, 24 September 2002 in the Senate Chamber. This will commence the evidence-taking process in relation to the Inquiry into child protection services. Members were reminded of the need to maintain a quorum throughout the proceedings.
8. Date and Time of the Next Meeting
The next meeting will be at 10.00am on Tuesday, 24 September 2002 in the Senate Chamber, Parliament Buildings. The normal weekly meeting will take place at 1.30pm on Wednesday, 25 September 2002 in Room 135, Parliament Buildings.
The meeting ended at 4.45 pm.
DR J HENDRON
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