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

Apologies:
Dr J Hendron (Chairman)
Mrs A Courtney
Mr J Kelly
Ms M McWilliams
Mrs I Robinson

In Attendance:
Mr P Hughes (Committee Clerk)
Mr D Harkin (Assistant Clerk)
Mr D Gordon (Executive Support)
Ms L Dempster (Administrative Support)
Mr B Greene (Administrative Support)
Dr J Thompson (Assembly Researcher)

Mr Gallagher took the Chair at 2:05 pm.

Private Session

1. Deputy Chairman's Opening Remarks

i.The Deputy Chairman reported briefly on the visit of 18 April to Action Cancer House, where members were impressed with the range of innovative services and excellent facilities for cancer patients.

ii.The Deputy Chairman reported on the informal meetings with Foyle View Parents' Support Group and Kilronan Parents' Action Group, at which the representatives highlighted problems arising from the lack of support for young people with physical and learning difficulties once they reach the age of 19. There was deep concern about the effect on these vulnerable young people's educational and social development of the withdrawal of day care facilities.

Agreed: The Clerk will write to the Department to request a paper on its policy on children and young people with physical and learning difficulties, including how this vulnerable group is covered under its developmental bids, as part of the draft Position Report. The Clerk will also invite the four HSS Boards to brief the Committee on the provision of day care services for special needs children and young people.

iii.The cancellation at short notice of the morning visit to BT Tower due to members' unavailability to attend will be raised at next week's meeting, when the Committee will consider the possibility of rescheduling a future visit.

iv.The Deputy Chairman reported on the informal meeting with the Northern Ireland Board of Occupational Therapists, when members were briefed on the supply problems that needs to be addressed through the Department's workforce plan, and the need for funding to address training and research development.

v.Agreed: Following the informal meeting with Brook Advisory Clinic on 10 April, when the organisation had called for the Committee's support on its work on sexual health education and funding, it was agreed that the Clerk would arrange a formal meeting in public session. The Committee will decide on any further action thereafter.

Public Session

Agreed: The draft minutes of the meeting of 17 April 2002 will be amended to reflect Ms Ramsey's concern about the shortage of environmental health officers in Belfast.

3. Matters Arising

i.Agreed: Members agreed the draft article, as amended, by the Committee Chairman for the Parliamentary Monitor magazine on health policy and the work of the Committee post-devolution.

ii.The letter from the Environment Committee in relation to mobile phone masts highlighting public concerns about the interference between radio transmitters and cochlear implants will be discussed at next week's meeting.

iii.In relation to the informal meeting with the Health Professionals Council on 16 April, the Clerk is checking with the Department the position on registration with regard to GB and the Republic of Ireland.

[2.35 pm]

4. Subordinate Legislation

i.Statutory Rule No. 129/02 - The Health and Personal Social Services (Superannuation) (Additional Voluntary Contributions) (Amendment) Regulations (Northern Ireland) 2002

Question put and agreed to:

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

Statutory Rule No. 129/02 - The Health and Personal Social Services (Superannuation) (Additional Voluntary Contributions) (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.

ii.Statutory Rule No.144/02 - The Adoption of Children From Overseas Regulations (Northern Ireland) 2002

The Committee deferred consideration of the above Statutory Rule pending clarification from the Department on how it intends to ensure that prospective adopters comply with the requirement to notify their local HSS Trust within 14 days of the child's arrival that they intend to apply for an adoption order here. In terms of the effectiveness of the monitoring arrangements, members queried whether there was a back-up mechanism whereby the authorities were alerted if and when prospective adopters failed to notify them of the child's arrival.

iii.Health and Personal Social Services (Penalty Charge) Regulations 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 (Penalty Charge) Regulations 2002.

Agreed: The Clerk will write to the Department to request details of control measures to counter prescription fraud perpetrated by health care professionals.

iv.Health and Personal Social Services (2001) Act (Commencement No.4) Order 2002

The Committee noted the Health and Personal Social Services (2001) Act (Commencement) No.4) Order 2002. This brings into operation Section 48 of the Health and Personal Social Services Act (Northern Ireland), which introduced new provisions aimed at reducing the evasion of health service charges.

[2.45 pm]

5. Spending Review 2002 - DHSS&PS Draft Position Report

Departmental Officials: Mr Clive Gowdy, Permanent Secretary

Mr Don Hill, Deputy Secretary

Mr Andrew Hamilton, Director of Financial Management

Mr John Allen

Rev R Coulter left the meeting at 3.00 pm.

The meeting was suspended at 3.40 pm and resumed at 3.55 pm.

Mr Gowdy gave a brief overview of the Department's Draft Position Report, which was followed by a question-and-answer session. The main points arising from the discussions are summarized as follows:

• In the light of the current significance being given to investment in health in GB and the Republic of Ireland there is a strong public expectation that the Executive will also make a substantial investment in health, social services and public safety.

• Levels of need for health service funding are demonstrably higher than those for England, but overall funding falls far short of what is needed to match demand levels. The current Needs and Effectiveness Evaluation is providing independent evidence of an underfunding of health and social services in Northern Ireland. This is estimated at £300m p.a. Mr Gowdy advised that any attempt to deliver health care on the cheap would inevitably result in poorly performing and inadequate/unsafe services.

• Substantial investment will be required just to maintain existing levels of services: the costs of developing new technology, drugs, and meeting pay awards tend to exceed inflation. Of the £600m made available to the Department by the Executive to date, £500m was needed to meet the costs of existing services. An extra £129m will be needed in 2003/04 just to maintain existing services. This rises to £356m in 2004/05 and £553m in 2005/06.

• The Minister of Finance has indicated that he will recommend to the Executive that the full allocation from the Chancellor's Budget announcement should be given to health. Even if the Department received that full allocation, the sum would not allow all its needs to be met. While the Chancellor's budget will provide for a year-on-year increase of 10% for health expenditure in England, Northern Ireland would need an additional 11% each year just to maintain existing levels of service. However, the Barnett Formula allows for an uplift of only 7.7%, which is £60m short of matching the growth in England. The deficit increases over the five-year period to almost £500m in 2007/08, making the total shortfall £1 billion over the period.

• The Needs and Effectiveness Evaluation indicates that the management costs of the Health Service in Northern Ireland are broadly comparable with GB. The Department will provide the Committee with a paper on benchmarking of unit costs for all surgical specialties, together with management and administrative costs.

• The cost base for health services is largely maintained elsewhere. Assumptions on pay awards alone take up a year-on-year spending increase of £63m. Treasury anticipates that changing grades and skill mix will add 1.25% p.a. to the pay bill.

• The 2% increase to the employers' contribution to the superannuation scheme and the 1% increase to employers' national insurance contribution from 2003/04 will add almost £45m to the cost base. The changes to the junior doctors' contract will require a further £10m. Changes to contracts for consultants and GPs are expected to add some £20m to the pay bill.

• The Department is making provision for an increase of 3.5% for goods and services. The community drugs bill is increasing by 10% p.a. These two issues account for £50m p.a. Provision in the Position Report for new drugs will feature in both "maintaining existing services" and "developmental bids".

• The Department hopes to increase tariffs for residential and nursing homes over the spending review period to bring about an uplift of 10% in real terms by 2005/06. This would bring the basic rate close to £400 per week. The Department will provide a paper on its strategy to increase funding for the residential care sector.

• Demographic trends alone mean that, in order to continue to provide current levels of service, increases of 0.54% rising to 1.83% will be required over the spending review period. This equates to some £10m-£16m.

• The Department's new requirement to cover the future costs of liabilities associated with the Fire Authority pension scheme is expected to add £13m-£14m p.a. to the overall resource costs.

• The Public Service Agreement will clearly identify how the Department is intending to use the different block allocations of resources. This will correspond with the Working for a Healthier People aspect of the new Programme for Government.

• The Regional Cancer Centre remains the Department's highest capital priority and there is a clear commitment that this will be delivered. A bid has been made against the Executive Programme Funds (EPFs) for the project, but, as a failsafe mechanism, a bid has also been made under the normal capital provision. Success in any of the EPF bids will not reduce the overall capital bid; the Department would then bring forward other schemes.

6. Review of Community Care

Agreed: The Clerk will write to invite Departmental Officials to present the First Report on the Review of Community Care, at next week's meeting.

7. Committee Work Programme

Agreed: In view of the numbers of members not present, it was agreed to defer this item until next week's meeting, when the Clerk will table a draft work programme and solicit members' views on possible areas for a focused inquiry, for completion before the Assembly's dissolution early next year.

[4.00 pm]

8. HPSS Bill (NIA Bill 6/01)

Royal College of Midwives: Ms Breedagh Hughes

Shadow NIPEC: Ms Paddy Blaney, Acting Chief Executive

The Committee took oral evidence from the above sets of witnesses in relation to the provisions for the establishment of the NI Practice and Education Council for Nurses and Midwives. The entire proceedings are recorded in separate verbatim minutes of evidence. The main points made by the witnesses were as follows:

• The RCM welcomes the establishment of NIPEC as a non-departmental public body and the fact that staff from the Nursing Board NI will transfer to the new body with full protection of terms and conditions of employment.

• The organisation believes that NIPEC will contribute to the development of clinical and social care governance by setting standards and monitoring the quality of education and practice of the nursing profession. The proposal that NIPEC will support the development of the role of healthcare support workers is welcomed.

• The RCM hopes to see the introduction of the direct entry midwifery education as soon as possible.

• It welcomes the proposed balance between practising nurses, midwives, health visitors and lay members but is concerned that all nominations to the Board are to be made by the Department,

• The RCM would seek clarification of the proposal under Section 2 (4) (a), which states that the Council shall act "in accordance with any directions given to it by the Department".

• The RCM would seek clarification on the details to be held on database in relation to training and qualifications.

• Ms Blaney advised that the Council's functions of practice, education and performance would recognize and support the huge change in the role of nurses, who work in criminal courts, schools and industry, as well as their natural settings. The 40% representation of laypersons on the Council will bring an extra dynamic.

• The arrangements are flexible and places on the Council can be set aside to allow for secondments for particular pieces of work.

[4.40 pm]

9. AOB

i.Extension of the Committee Stage - Children (Leaving Care) Bill

Question put and agreed to:

That, in accordance with Standing Order 31(5), the period referred to in Standing Order 31(3) be extended to 26 June 2002, in relation to the Committee Stage of the Children (Leaving Care) Bill.

ii.Agreed: The Clerk will investigate the possibility of the Committee's receiving a presentation on the findings of the Wanless Report on the long-term trends affecting the health service by a member of its Review team.

iii.Agreed: The Committee noted the HM Fire Service Inspectorate Report on the Fire Authority for Northern Ireland. It was agreed that the Clerk would write to the Department to request a report on the action being taken against the Report's 11 recommendations.

iv.Agreed: Further to a request by NIPSA Social Services sub-committee for a meeting with the Committee on 22 May as part of a proposed day of action to highlight resources available for implementation of the Children Order 1995, the Clerk will arrange a mutually convenient meeting time.

10. Date and Time of the Next Meeting

The next meeting will be at 2:00 pm on Wednesday, 01 May 2002 in Room 135, Parliament Buildings.

The meeting ended at 4.45 pm.

MR T GALLAGHER
COMMITTEE DEPUTY CHAIRMAN
April 2002

17 April 2002 / Menu / 1 May 2002