MINUTES OF PROCEEDINGS OF THE HEALTH, SOCIAL SERVICES AND PUBLIC SAFETY COMMITTEE
AT 2.00 PM ON TUESDAY, 14 MAY 2002
IN ROOM 152, PARLIAMENT BUILDINGS

Present: Dr J Hendron (Chairman)
Rev R Coulter
Mrs A Courtney
Mr T Gallagher (Deputy Chairman)
Mr T Hamilton
Mr J Kelly
Ms M McWilliams
Mrs I Robinson

Apologies: Mrs P Armitage
Mr P Berry
Ms S Ramsey

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

Dr Hendron took the Chair at 2.06 pm.

Private Session

1. Chairman's Opening Remarks

i. The Chairman thanked the Committee and staff for their tremendous support over the last few weeks, both collectively and individually, when he was recovering from his recent operation.

ii. The Chairman reported briefly on his very informative visit yesterday with the North Belfast Partnership Board, where the discussions had concentrated on children's mental health, drug/alcohol abuse and a local voluntary initiative, Cancer Lifeline. A briefing paper on the visit has been issued to members.

Public Session

2. Minutes of the Last Meeting

The minutes of the meeting of 08 May 2002 were agreed.

[2.15 pm]

3. Matters Arising

i. Agreed: The Committee agreed the draft response to the Department's consultation paper on the Review of Community Care. The Committee will continue to monitor closely the detailed proposals for implementation of the community care strategy.

Concern was raised about the consequence of Trusts' overspends on community care in 2001/02 for new care packages in 2002/03, with the prospect of more delayed hospital discharges as a consequence. The Clerk advised that the issue of the Department's bids could be reconsidered in June, when the Executive is due to produce its Position Report on the 2002/03 Budget.

Agreed: The Clerk will include a request to the Department to outline its policy in relation to Trust overspends, in the Committee's follow-up letter to the concerns raised by the Eastern HSS Board about the service restrictions imposed by the funding limitations for 2002/03.

ii. Agreed: The Committee agreed the draft letter, as amended, to the Department asking for its response to the concerns outlined by the Mental Health Commission, both at its recent informal meeting with the Committee and in written correspondence.

In relation to concerns raised by a member about the recording of suicides and attempted suicides, the Clerk will write to the Department to request details of how these statistics are treated.

[2.25 pm]

4. Health and Personal Social Services Bill: Committee Stage

Departmental Officials: Mr Peter Deazley
Mr John McKeown

Clause 1 (Charges for Nursing)

The Committee resumed its clause-by-clause consideration of the HPSS Bill, and the entire proceedings are recorded separately in verbatim minutes of evidence.

Mr Deazley explained that the Department was examining how an existing model review system within the Department could be adapted and developed to take account of the nursing care assessment process. This system requires the assessment to be reviewed within one week to the satisfaction of the service user, the carer or other interested parties. Where it is not satisfactorily resolved, a panel must be constituted and a further review completed within two weeks.

Mr Deazley advised that the Department proposes to issue a statutory direction to the Boards and Trusts that will incorporate the guidance and the review process. He assured the Committee that the Department would widely disseminate the directions and guidance in relation to the nursing care assessment. A nurse would carry out the initial assessment, but a different nurse assessor would undertake the first review.

Mr Deazley advised that the Department should be in a position to provide the Committee with details of the assessment tool, the recommendation on the payment mechanism, and the evaluation from the pilot studies by next week.

The Committee suspended further clause-by-clause scrutiny of the Bill until next week's meeting, when Departmental Officials will be re-invited to attend.

[2.40 pm]

Mr Gallagher left the meeting at 2.40 pm and returned at 2.47 pm.

5. Committee Work Programme

The Clerk outlined the Committee's forward work schedule, which will include the Committee Stage of three Bills, and the provisional timetable for any inquiry to be completed before the Assembly's dissolution in spring 2003.

The Committee deliberated on a number of options for an inquiry.

Agreed: The Committee selected the area of child protection for its next inquiry. The Clerk will draft focused terms of reference for consideration at next week's meeting, as the Committee's aim is to report to the Assembly in early 2003. The Clerk will draft a press release, for the Chairman's approval, announcing the launch of the inquiry.

[3.25 pm]

6. Protection of Children - The Baby Jasmine Case

Witnesses: Mr Paul Martin, Chief Inspector of the Social Services Inspectorate
Ms Kate Thompson, Director of Social Services, Down Lisburn HSS Trust
Mr Alan Finn, Director of Nursing, Down Lisburn HSS Trust
Mr John Clarke, G7 Community Childcare

The entire proceedings relating to this item are recorded separately in verbatim minutes of evidence.

Mr Martin provided the following statistics, in order to set the context in which the health and social services professionals are trying to provide a child protection service in Northern Ireland:

• In 2000/01 per capita expenditure on children's services in Northern Ireland was £179 per child, which was £75 less than the corresponding figure for England. This equates to 40% less expenditure on family and childcare programmes compared to England.
• In 2000/01, over 16,000 children were referred to social services, which was a 23% increase over a three-year period.
• In 1999, which is the most recent year for which figures are available, 14,456 incidents of domestic violence were reported to the police - 93% of these were witnessed by children.
• During 2000/01, there were 2,360 child protection investigations, of which 78% were carried out by social workers and 20% under joint protocol with social workers and the police.
• At present, 1,414 children are on the child protection register. This is a rate of 30.7 children per 10,000 head of the population under 18, and significantly higher than the corresponding figure for England, which is 23.8.

Ms Thompson advised that the Trust was currently undertaking a case management review of the tragic circumstances surrounding the death of Jasmine McGowan, which would be presented to the Minister by June 2002. She assured the Committee that the lessons learnt from the review would be openly shared and that there would be an investigation of how the Trust dealt with concerns raised by community groups and individual neighbours about the baby's welfare. Ms Thompson undertook to report to the Committee in June on the recommendations from the initial management review of the case, which have already been acted upon.

Mr Finn confirmed that, as a consequence of the review, the Trust has appointed a full-time child protection nurse specialist. It has also had external validation of all its child protection policies and has reintroduced multidisciplinary training programmes for all staff, which had been suspended because of resource problems. Also, the GPs in the Trust area have all been alerted to the medical factors in the case. Ms Thompson acknowledged the importance of examining the context and pattern of behaviour in such cases, as well as the extent and quality of communication between childcare professionals.

Members expressed disquiet that, in spite of the intervention and support of health visitors, social workers, midwives, and medical staff at the Children's Hospital, the tragedy had not been prevented. Mr Finn assured the Committee that the health visitor and social worker involved were both very experienced and had recent training in child protection.

There are four centres run by the NSPCC in partnership with local Trusts providing early intervention and parenting support to families, including those whose children may be on the at-risk register. Mr Martin advised that revised guidance on child protection has been drawn up following a number of case management reviews, which are ready for issue.

7. AOB

i. Agreed: The Clerk will request a briefing paper from the Assembly Research Services on the Department's proposals for Equality Impact Assessments.

ii. Agreed: The Clerk will seek further information on the impact of NHS funding cuts, as outlined in a letter to the Committee by the Homefirst - Staff Side Committee seeking a meeting to discuss the concerns.

iii. The Committee noted the consultation paper on adult literacy by the Department of Employment and Learning, 'Essential Skills for Living Strategy'.

iv. The Committee noted the NHS Confederation paper 'Shifting the Balance of Power within the NHS' and the Freedom of Information Act, which were recently issued.

v. The Clerk advised that the booklet 'Developmental Youth Arts Programme 1995-2000' by Wheel Works was available for members' consultation.

vi. The Committee noted a Department of Finance and Personnel memorandum on the 6th Report of the Public Accounts Committee Session 2001/02 on pathology provision in Northern Ireland.

vii. The North and West Belfast HSS Trust has written to offer the Committee a presentation on a piece of research 'Caring through the Troubles', which highlights the cost of the Troubles in terms of delivering health and social services in North and West Belfast. An immediate decision was deferred in light of the Committee's work programme.

viii. Agreed: The Clerk will arrange for a weekly list of correspondence received to be copied to members in advance of the Committee meeting, including, where appropriate, reference to any follow-up action required. Copies of letters can be made available to members on request, for discussion at the next Committee meeting.

8. Date and Time of the Next Meeting

The next meeting will be at 2.00 pm on Wednesday, 22 May 2002 in Room 135, Parliament Buildings.

The meeting ended at 4.15 pm.

DR J HENDRON
COMMITTEE CHAIRMAN
May 2002

8 May 2002 / Menu / 22 May 2002