MINUTES OF PROCEEDINGS OF THE HEALTH, SOCIAL SERVICES AND PUBLIC SAFETY COMMITTEE AT 2:00 PM ON WEDNESDAY, 20 MARCH 2002 IN ROOM 135, PARLIAMENT BUILDINGS

Present: Mr T Gallagher (Deputy Chairman)
Mr P Berry
Rev R Coulter
Mr T Hamilton
Mr J Kelly
Ms S Ramsey

Apologies: Dr J Hendron (Chairman)
Ms P Armitage
Mrs A Courtney
Mrs I Robinson

In Attendance: Mr P Hughes (Committee Clerk)
Mr D Harkin (Assistant Clerk)
Mr D Gordon (Executive Support)
Mrs K McFerran (Executive Support)
Ms L Dempster (Administrative Support)
Mr B Greene (Administrative Support)

Mr Gallagher took the Chair at 2:03 pm.

Private Session

1. Deputy Chairman's Opening Remarks

The Deputy Chairman reported briefly on the lunchtime meeting that he had with trade union representatives of the Ambulance Service and Fire Brigade concerning a range of issues. These included the numbers of recent attacks on their members when attending emergencies, funding comparisons with GB, and conditions of service. He advised members that a commitment had been given to the union representatives for a full public meeting with the Committee at a suitable future date to discuss the issues further.

2. Minutes of Proceedings

The Minutes of Proceedings of 13 March 2002 were agreed.

[2.10 pm]

Public Session

3. Matters Arising

The Clerk advised members that a paper has been commissioned from the Assembly Research Services on waiting lists. This will inform the Committee's scrutiny of the latest figures when it reconsiders the matter after the Summer Recess.

4. Subordinate Legislation

i. Health and Personal Social Services (Superannuation) (Superannuation Scheme and Additional Voluntary Contributions) (Pension Sharing on Divorce or Annulment) Regulations (Northern Ireland) 2002

Agreed: That the Health, Social Services and Public Safety Committee is content with the Department's proposal for the Health and Personal Social Services (Superannuation) (Superannuation Scheme and Additional Voluntary Contributions) (Pension Sharing on Divorce or Annulment) Regulations (Northern Ireland) 2002.

ii. Statutory Rule No. 91/02 - Charges for Drugs and Appliances (Amendment) Regulations (Northern Ireland) 2002

Question put and agreed to:

That the Health, Social Services and Public Safety Committee has considered:

Statutory Rule No. 91/02 - Charges for Drugs and Appliances (Amendment) Regulations (Northern Ireland) 2002

and, subject to the Examiner of Statutory Rules being satisfied as to its technical correctness, has no objection to the Rule.

iii. Statutory Rule No. 84/02 - Dental Charges (Amendment) Regulations (Northern Ireland) 2002

Question put and agreed to:

That the Health, Social Services and Public Safety Committee has considered:

Statutory Rule No. 84/02 - Dental Charges (Amendment) Regulations (Northern Ireland) 2002

and, subject to the Examiner of Statutory Rules being satisfied as to its technical correctness, has no objection to the Rule.

iv. Statutory Rule No. 85/02 - Optical Charges and Payments and General Ophthalmic Services (Amendment) Regulations (Northern Ireland) 2002

Question put and agreed to:

That the Health, Social Services and Public Safety Committee has considered:

Statutory Rule No. 85/02 - Optical Charges and Payments and General Ophthalmic Services (Amendment) Regulations (Northern Ireland) 2002

and, subject to the Examiner of Statutory Rules being satisfied as to its technical correctness, has no objection to the Rule.

[2.20 pm]

5. Presentation by Northern Ireland Trust Nurses Association

Panel Member: Prof. Sydney Salmon, Chairperson NI Trust Nurse Association

Prof. Salmom made a brief presentation in respect of the Association's views on the Local Health and Social Care Groups (LHSCGs). The briefing and follow-up question-and-answer session are summarised as follows:

• The Trust Nurse Association believes that the new arrangements will bring a balanced and inclusive approach to primary, secondary and tertiary care services and future developments, which should improve services for patients and carers. The Association would welcome further discussion with the Royal College of Nursing (NI) to tease out the valid issues of concern.

• Community nurses, midwives and health visitors are very worried about their future and the Department must map out a cohesive and clear framework for the way forward if these legitimate fears are to be allayed.

• There should be no delay in getting the new LHSCGs in place, as this would run the risk of losing momentum and jeopardize the good collegiate work of GP Groups and the multi-professional approach of the health and social care groups.

• The new arrangements will provide nurses with an appropriate statutory forum, alongside GP colleagues and other health and social care professionals, in the formal planning process for primary care. It is important that community nurses be allowed an equal say with other primary care professionals in the development of services, as historically others were perceived to be more powerful members of the team.

• Strategies employed will include the involvement of clinical nurse specialists.

• Advocate senior nurse spokesperson on LHSCG management board as an appropriate conduit for feeding in front-line nursing issues. Senior nurses have considerable experience on the local commissioning primary care groups. They understand the strategy of the HSS Boards' framework for National Service Development, as well as issues surrounding clinical governance and evidence-based practice and regional policy frameworks.

• Nurse professionals working at Executive level in HSS Trusts are kept fully aware of local primary care issues through clear communication channels with their grassroots colleagues. They also have a detailed knowledge of local health policy and of wider developments in GB.

• Nurses will require considerable training to equip them with the necessary skills required under the new primary care system, particularly in relation to commissioning health care services.

• The Trust Nurse Association wants to see a clear strategy, policy framework and objectives for primary care being developed immediately and will keep a close watch that what has been promised in this regard is delivered through the new LHSCGs.

• An equal voice for all on the LHSCGs will be achieved through teambuilding initiatives such as the TARGET project, which involved all the various components of a primary care team, including administrative staff, meeting away from the surgery to discuss primary care issues. The LHSCGs' strength will be built up from a consensus basis with mutual respect for the views of the primary care professionals and the service users.

[2.55 pm]

6. Draft Service Delivery Agreement (SDA)

Departmental Officials: Mr Paul Simpson, Deputy Secretary
Mr Don Hill, Deputy Secretary
Mr Andrew Hamilton, Director of Finance

The panel gave a presentation of the draft SDA for 2002/03 followed by a question-and-answer session, which is summarised below:

• Objective One deals with promoting policies. The final SDA will set a June target date for the Tobacco Action Plan and a Summer target for the teenage parenthood and mental health strategy. The document seeks to incorporate all the developmental activities that the Minister has announced.

• The Department will be in a position to publish the Investment for Health Strategy paper before the end of March 2002.

• Objective Two: the document details the additional £0.3m for modernisation of the Ambulance Service, £0.65m of Executive Programme Funds (EFPs) for Digital Trunk Radio and £0.42m to introduce Rapid Responder services in rural areas. It now also includes all the actions announced by the Minister in relation to regional hospital services, which will be brought forward by the HSS Boards in their Health and Well-Being Investment plans, which are due for approval at the end of May 2002. The Minister has made available £12.3m to take forward those actions.

• An additional £4.5m has been made available to support the introduction of free nursing care.

• An additional £14.6m has been made available to provide 1,000 additional community care packages by March 2003, to develop respite care and increase by 5.5% fees payable for residential and nursing care places.

• In primary care, the document incorporates the additional £1.8m to support the new arrangements.

• An additional £2m has been incorporated for Children's Services.

• The Department will forward the recommendations from the interim report on the delivery of community care, which identify areas where improvements can be made.

• In reference to a query on the commitment in the SDA to implement identified improvements in community care by March 2002, the Officials advised that all target dates would be the subject of detailed checking before the final document is published.

• A paper has been finalised on the pre-consultation process in relation to the Hayes Review, which the Executive will discuss in the near future. This paper sets out in summary what the Minister intends to include in the consultation. There is no question of the Hayes Report being shelved.

• In terms of the Budget, the Department will produce a position report on the three Spending Review years by mid-April. The major demands of the Acute Hospitals Review will be an essential feature of that report. This is the first time that the Executive has tackled a 3-year Spending Position, which makes it a very important survey for the Department.

• The Officials undertook to advise the Committee on how it will be notified of the final SDA. Members made it clear that they wished to be consulted on the document in advance of its publication.

• Under Target 2.1 the Department will expand on the information relating to improvements to be made to the Ambulance Service on the basis of the additional resources.

• The prudence of the waiting list targets is in relation to the success or otherwise of achieving extra funding to tackle this problem.

• The Department undertook to re-examine the drafting of Target 2.14 in relation to the commitment to fund part-time teacher support in children's residential care homes.

• The Department will amend the wording of Target 2.5 to reflect the fact that the Boards and Trusts are already implementing the Framework for Action on Waiting Lists.

• Objective Three now includes the Executive Programme Funds in terms of the Fire Service; otherwise it remains as previously indicated.

• The Minister has asked her Departmental Officials to discuss the issue of what constitutes an "emergency service" with the Fire Brigade and Ambulance Service trade unions.

• The Department can pursue a fixed penalty charge up to a maximum of £100 for prescription fraud through the commencement of legislation, which provides for criminal offence.

• The Department will take on board the fact that prescription fraud can be perpetrated by, for example, pharmacists and doctors, and reflect this in the final document.
  
  Agreed: The Clerk will prepare a draft composite response to the SDA, for the Chairman's approval, which will request that the final document take account of members' comments.

[3.50 pm]

7. Review of Public Administration

Agreed: The Committee agreed, as amended, the draft response to the draft terms of reference for the Review of Public Administration. Members were concerned to ensure that the Review should be carried out without undue delay and that it should include the views of the local district councils.

[4.00 pm]

8. Regional Transportation Strategy

Agreed: Members considered and approved the Committee's draft response, as amended, to the proposed Regional Transportation Strategy.

9. Inquiry into EU Structural Funds

The Committee noted a letter from the Chairman of the Finance and Personnel Committee inviting Statutory Departmental Committees to give evidence in relation to its inquiry into European Structural Funds and Community Initiatives. The Clerk advised members that the HSS&PS Department does not have a role to play in acting as a paying authority, lead Department, or as an implementing body for any of the programmes.

Agreed: The Chairman will write to the Chairman of the Finance and Personnel Committee to decline the offer to give evidence.

[4.10 pm]

10. Committee Work Programme

Agreed: The Committee agreed that, due to the absence of a number of members, it would defer consideration of its work programme for April to July 2002 until after the Easter Recess. A draft work schedule will be presented for consideration at the Committee meeting scheduled for 10 April 2002.

11. AOB

i. The Committee noted correspondence from the charity Speechmatters, a support network for aphasic adults, setting out its case for increased Departmental funding.

Agreed: The Clerk will forward the correspondence to the Department for consideration.

ii. The Clerk drew members' attention to a letter from the Chairman of the Social Development Committee in relation to that Committee's Inquiry into Homelessness. Members agreed that this was a cross-cutting Departmental issue with clear implications for health. Also, given the high numbers of homeless young people from a social care background, the Committee was concerned to ensure that there should be a clear "read-across" between the provisions of the Children Leaving Care Bill and the proposed Housing legislation.

Agreed: The Clerk will forward the letter to the Department for information.

iii. Agreed: Following a letter from Foyle View Parents' Support Group requesting a meeting with the Committee to discuss difficulties in the provision of services to children and young people with severe learning difficulties and physical disabilities in the North West, the Clerk will arrange an informal lunchtime briefing in Parliament Buildings.

As a follow-up to this meeting, the Clerk will arrange for representatives from the four HSS Boards to attend a full Committee meeting to discuss the provision of services for this vulnerable group across the region.

iv. Agreed: In response to a request from the Northern Ireland Hospice Care for a meeting with the Committee to discuss its financial position, the Clerk will arrange an informal lunchtime meeting in Parliament Buildings.

v. The Clerk will also request an update from the Department on the latest position regarding the Children's Hospice following the award of damages against its former Director.

vi. Agreed: In response to a written request from Kilronan Parents' Action Group for a meeting with the Committee to discuss care and education opportunities for children with special needs in the 19+ age group, the Clerk will arrange an informal lunchtime meeting in Parliament Buildings.

vii. Agreed: In response to a written request from Mrs Kelso, community midwifery sister, the Committee will sponsor a Breastfeeding Health Promotion Display in Parliament Buildings to coincide with National Breastfeeding Awareness week from 18-22 May 2002.

In the light of the Committee's recent inquiry into cancer services, the Clerk will also investigate the possibility of its sponsoring a Breast Screening Promotion Display to run concurrently with the above two events in Parliament Buildings.

viii. Agreed: In response to a letter from the Eastern Local Medical Council highlighting concerns about the ability of secondary medical care in Northern Ireland to cope with its workload, the Clerk will arrange an informal lunchtime meeting between the Committee Chairman and representatives from the Council in Parliament Buildings to discuss the issues.

ix. Agreed: In response to a letter from the Mental Health Commission for Northern Ireland drawing attention to communication problems that it is experiencing with the Department, the Committee will hold an informal lunchtime meeting with the Commissions' Chairperson in Parliament Buildings to discuss the matter in depth.

x. The Clerk briefed members on the House of Lords Select Committee's inquiry into the working of devolution. He advised that the Select Committee would be visiting Belfast in June to take evidence on the Constitution, when the Clerk would examine the impact of this inquiry on local health and services provision, and related areas such as the Barnett Formula.

xi. The Committee noted a letter from a local district councillor urging support for front-line health services and streamlining of administration.

xii. The Committee noted a letter from the Heart Failure Forum highlighting concern that heart failure was not addressed specifically by the Cardiac Services Review in Northern Ireland and that specialist nurses should be provided across the region to enable full benefits to be achieved.

xiii. The Committee noted the quarterly service monitoring report of the Eastern HSS Board.

xiv. On behalf of members, the Deputy Chairman extended best wishes to staff member Mrs McFerran, who is due to go on maternity leave, and thanked her for providing excellent support services to the Committee.

11. Date and Time of the Next Meeting

The next meeting will be at 2:00 pm on Wednesday, 10 April 2002 in Room 135, Parliament Buildings.

The meeting ended at 4:22 pm.

MR T GALLAGHER
COMMITTEE DEPUTY CHAIRMAN

March 2002

13 March 2002 / Menu / 10 April 2002