Present:
Dr J Hendron (Chairman)
Mr P Berry
Rev R Coulter
Mrs A Courtney
Mr T Gallagher (Deputy Chairman)
Mr T Hamilton
Mr J Kelly

Apologies:
Mrs P Armitage
Ms M McWilliams
Ms S Ramsey
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)

1. Chairman's Opening Remarks

i.The Chairman reported briefly on the successful morning visit to the Northern Ireland Ambulance Service Control Centre at Knockbracken and advised that a briefing note would issue to members.

ii.The Chairman reported on the successful launch by Speechmatters of aphasia awareness week, which he had sponsored in the Long Gallery on Monday, 27 May. He commended the work of Speechmatters in highlighting the need to provide professional help and support for individuals to adapt to living with communication impairment.

iii.The Chairman referred to an event organised by Ulster Cancer Foundation in Parliament Buildings on Monday, 27 May, titled 'Cancer Information in Jeopardy'. He referred to the benefits of quality cancer registration, in terms of the collection, analysis and presentation of information on cancer patients, which will provide a benchmark from which to measure future improvements in service.

Public Session

2. Minutes of Proceedings

The minutes of the meeting of Wednesday, 22 May 2002 were agreed.

3. Matters Arising

i.The Chairman advised that the Department has provided written confirmation that all future publications by the Food Safety Promotion Board will be copied to the Committee.

ii.The Chairman advised that the Minister is due to make a statement in the Assembly on the Human Organ Retention Inquiry on Wednesday, 05 June 2002.

4. Subordinate Legislation

i.Contaminants in Food Regulations (Northern Ireland) 2002

Agreed: That the Health, Social Services and Public Safety Committee is content with the Department's proposal for Contaminants in Food Regulations (Northern Ireland) 2002.

ii.Pharmaceutical Society of Northern Ireland (General) (Amendment) Regulations (Northern Ireland) 2002

Agreed: That the Health, Social Services and Public Safety Committee is content with the Department's proposal for Pharmaceutical Society of Northern Ireland (General) (Amendment) Regulations (Northern Ireland) 2002.

iii.Statutory Rule No. 171/02 - General Dental Services (Amendment No.2) Regulations (Northern Ireland) 2002

Question put and agreed to:

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

Statutory Rule No. 171/02 - General Dental Services (Amendment No.2) Regulations (Northern Ireland) 2002

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

iv.Statutory Rule No. 172/02 - Travelling Expenses and Remission of Charges (Amendment No.2) Regulations (Northern Ireland) 2002

Question put and agreed to:

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

Statutory Rule No. 172/02 - Travelling Expenses and Remission of Charges (Amendment No.2) 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.

v.Statutory Rule No. 181/02 - Health and Personal Social Services (Penalty Charge) Regulations (Northern Ireland) 2002

Question put and agreed to:

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

Statutory Rule No.181/02 - Health and Personal Social Services (Penalty Charge) 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.

[2.20 pm]

Mr Kelly and Mr Gallagher joined the meeting at 2.20 pm and 2.24 pmrespectively.

5. Health and Personal Social Services Bill: Committee Stage

Departmental Officials: Mr Peter Deazley

Ms Janice Smyth

Mr John McKeown

Mr Deazley spoke to a briefing paper in relation to the consultation on the nursing needs assessment tool, the fast track review mechanism, and the payment system. He outlined the main points from the paper, which are summarized as follows:

The terms of reference for the development of a nursing needs assessment were to review what was available in GB, as well as in Northern Ireland, and then to measure those tools against the National Service Frameworks. The information would then be used to develop a tool responsive to the nursing needs of people in Northern Ireland.

The nursing needs assessment tool was piloted in seven sites across Northern Ireland, encompassing the four Board areas. Nurses from the Trusts and independent sector worked in partnership. The tool is now ready for stakeholder consultation.

The Minister has decided on a single rate payment system for nursing care, although the actual amount has not yet been settled. A survey is being carried out of the Trusts to determine how many fully or partly self-fund their nursing care, so that proposals can be put to the Minister on the weekly contribution towards nursing care. The payment will not be less than £85 per week.

The Department proposes to provide directions that will give statutory guidance on actions required by Boards/HSS Trusts to commence payments for nursing care in registered nursing homes from 07 October 2002. Trusts will be required to identify all nursing home residents who are funding their own care in nursing homes, and to inform those individuals, their families, carers or appointees of their right to an assessment for nursing care. Such an assessment will require the consent of the individual or their family or carer.

The assessment and review process requested by the Committee will be set out in detail. If not satisfied with an initial nursing care assessment, the individual concerned can request a review assessment, which will be carried out by a different nurse within one week. If that does not prove satisfactory, a review panel must be set up to hear the case within a further two weeks. In England, almost all appeals to date have been against assessments that placed an individual in either of the lower of the three tiers of nursing need. A single tier system for Northern Ireland should therefore reduce the number of review requests.

The Chairman acknowledged the importance of the Bill, in terms of correcting an anomaly faced by some 2,000 self-funding residents of nursing homes who have been put at a distinct disadvantage in comparison with those receiving free nursing care as a health service in their own home. Adopting the provisions of Clause 1 would be a necessary first step in ensuring basic equity of provision and ensure that Northern Ireland can provide similar benefits to those in England and Wales.

The Chairman placed on record the Committee's ultimate desire for free nursing and personal care, if the resources are available. The Committee awaits the report of the Working Group on Personal Care in June 2002 but notes that the costs are anticipated to be well in excess of £25m. The Assembly and Committee's future consideration of free personal care will be informed by the Executive's examination of the financial implications and the experiences of Scotland, where it has already been introduced.

The entire proceedings are recorded separately in verbatim transcripts of evidence.

Clause 1 - Charges for Nursing Care

Question put and agreed to:

That the Committee is content with the Clause.

[Clause 2 and the Schedule to the Bill were previously agreed to.]

Clause 3 - Interpretation

Question put and agreed to:

That the Committee is content with the Clause.

Clause 4 - Commencement

Question put and agreed to:

That the Committee is content with the Clause.

Clause 5 - Short Title

That the Committee is content with the Short Title.

Long Title

Question put and agreed to:

That the Committee is content with the Long Title.

Mr Kelly left the meeting at 2.40 pm.

The Clerk advised that a draft report on the Bill would be prepared for consideration at next week's meeting.

[2.45 pm]

6. Children Leaving Care Bill: Committee Stage

Children's Law Centre: Ms Tara Caul

Mr Liam Mackle

Ms Caul summarised the main points from the Children's Law Centre as follows:

• Children and young people should inform the decision-making process and be directly consulted in relation to their proposed exclusion from the benefit system.
• It welcomes the introduction through the Bill of a duty to assess and meet the needs of each individual young person leaving care.
• It recommends that the new duty to assess and meet needs should apply to as many young people leaving care as possible and that any discretionary element should be removed.
• It recommends that the category of "relevant" children includes children and young people who at the time they reach the age of 16 are detained in hospital, or in a juvenile justice centre or young offenders centre.
• The question of additional resources must be addressed as a matter of urgency to support the implementation of the proposals. The introduction of a similar Bill in England was supported by new funding from the Children's Social Services Special Grant, as part of the Quality Protects Programme.
• There should be a duty on Trusts to prepare and review pathway plans for all young people leaving care and that the duty to review should last until the young person is 21, or 24 where they are continuing in education.
• Specific regulations should be introduced to cover "suitable accommodation" for care leavers. This would require detailed consultation.
• In terms of the provision of financial assistance, the term "maintaining" needs to be more specifically defined.
• There should be a legal duty on Trusts to assist with costs associated with a young person's education up until they are 24.
• The Centre recommends that Clause 6 should be deleted and that "relevant" care leavers should be entitled to income support. This would allow the young person's adviser to concentrate on other aspects of the pathway plan. Also, if the young person were to become estranged from the Trust and their personal adviser, this would provide a safety net in terms of financial provision.

[3.00 pm]

North and West Belfast HSS Trust:
Mr Noel Rooney
Mr Tommy Boyle
Mr John Growcott

The main points raised by the Trust are summarised as follows:

• Adequate resourcing for the legislation is essential. There have been well-documented problems with the implementation of the Children Order due to funding constraints. For example, advocacy for young people will create substantial resourcing demands. Also, children with physical or learning disabilities are a huge draw on resources.
• Concern was raised about how the proposed financial arrangement could impact adversely on the Trust. It was also felt that this could impinge on the independence of young people leaving care, as well as affecting the social work relationship with the young person. An aftercare fund could be developed to help maintain the relationship between social services and the young people by, for example, supporting them while they are at university.
• The implementation of a multi-agency approach amongst the key statutory, voluntary and community agencies is essential if the provisions of the Bill are to be a success. The Trust welcomes the centrality of the young person in the planning process. The service must straddle the continuum of needs to cover the diverse range of clientele.
• Appropriate accommodation provision is particularly important. One third of those leaving care are from children's homes and many of these have challenging behaviour. This highlights the need for a range of housing provision. The Department will need to work very closely with the Housing Executive.

The entire proceedings are recorded separately in verbatim transcripts of evidence.

Agreed: The Committee will commence its clause-by-clause consideration of the Bill at next week's meeting.

[3.25 pm]

Private Session

7. Inquiry into Protection of Children Services in Northern Ireland

Assembly researcher Dr Janice Thompson briefed members on a list of experts on child welfare and protection that she had drawn up as potential special advisers to the above inquiry. The Clerk explained the selection process and sought the Committee's approval to approach the experts listed.

Agreed: The Assembly Research Services will write to the experts listed seeking expressions of interest in acting as a specialist adviser to the inquiry. The Clerk will issue a press statement outlining the terms of reference for the inquiry.

Mr Hamilton left the meeting at 3.00 pm.

Public Session

8. AOB

i.The Clerk advised that the Department would shortly be forwarding a paper to the Committee on its Executive Programme bids under the third tranche.

ii.Agreed: The Committee agreed to the publication on the internet of the following papers previously prepared for it by the Assembly Research Services: PSS Amendment Bill, HPSS Bill, Best Practice-Best Care, Victims Strategy, and a background paper to the Cancer Inquiry.

iii.Agreed: The Clerk will arrange for Research Services to brief the Committee on the papers commissioned on HSS structures and hospital waiting lists in late June/early July. The paper on waiting lists will be up-to-date and will address the question of "hidden figures", vis-à-vis people waiting to get on to waiting lists.

iv.The Clerk will write to remind the Department of the Minister's outstanding response to the Deputy Chairman's letter requesting its policy in relation to the availability on the NHS of new drugs to treat severe rheumatoid arthritis.

v. The Committee noted an invitation from United Response Families Project to the launch of a mid-term research report at 11.00 am on Wednesday, 26 June 2002 at the Island Civic Centre, Lisburn.

vi. Members were reminded of the Committee visit to the Fire Control Centre in Lisburn, scheduled for 10.30 am on Thursday, 30 May 2002.

9. Date and Time of the Next Meeting

The next meeting will be at 2:00 pm on Wednesday, 05 June 2002 in Room 135, Parliament Buildings.

The meeting ended at 3.40 pm.

DR J HENDRON
COMMITTEE CHAIRMAN
May 2002