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

Apologies:
Mrs P Armitage

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 Hendron took the Chair at 12:20 pm.

Public Session

1. Executive Programme Funds and Investment and Reform Initiative

Departmental Officials:
Mr Don Hill
Mr John Clarke
Mr Leslie Frew
Mrs Maureen McCartney

The Officials briefed the Committee on the Department's proposed bids against the Executive Programme Funds and the Reinvestment and Reform Initiative (RRI). Decisions on the successful bids are expected to be announced before the July Recess.

Over 2002/03 and 2003/04, some £270m will be available through the Reinvestment and Reform Initiative. A further £77.9m will be available through the Innovation and Modernisation Fund, Social Inclusion and Community Regeneration, and the Children's Fund. A key concern of the Department in making bids against the funds is the ongoing cost that may flow into 2004/05 to have a project completed, as well as the recurrent costs that may flow from projects.

Agreed: The Clerk will write to the Department to request a breakdown of the successful bids made against each of the Executive Programme Fund allocations to date, including a percentage comparison of the funding received with the Health Service's mainstream allocation from the Block Grant.

Innovation and Modernisation Fund
The Department is submitting bids totalling £55m, which is 125% of the total amount available. The bids are summarised as follows:

• NI Regional PET/CT Institute- recurrent funding support and costs of clinical evaluation at the RGH.
• Person-centred Community Information System - to introduce a modern ICT support system for use by nurses/social workers/PAMs in the community. Professional time saved could amount to £0.5m per Trust.
• Cardiac Surgery Equipment
• Imaging Centre: a comprehensive diagnostic imaging service at the RGH
• HPSS quality and performance improvement fund - This proposal would establish a fund for innovative pilot schemes across the HPSS, to address problems associated with quality improvement and efficient service delivery.
• New regional secure inpatient psychiatric unit for disturbed adolescents - the centre would reduce the need to transfer such adolescents to GB for assessment and treatment. The Officials undertook to provide written clarification of the cost of the new unit and the number and type of specialist places available. The Department will, in future, identify where appropriate the relevant HSS Board and location for any proposed new schemes under such bids.
• Picture archiving and communicating system (PACS) - providing simultaneous access to imaging data at different locations, thus facilitating the treatment of cancer patients. Training and implementation costs form a significant component of the overall resources in relation to this and other bids.

In relation to concerns raised about data protection, the Officials indicated that there were many difficult issues yet to be resolved but that these can be overcome. The Department expects to issue a consultation document on data protection shortly. This will address the conflict between the individual's rights to privacy and what the health care system needs to improve the service it provides to other patients. The Cancer Registry is a very good example.

The Committee emphasized the importance of empowering patients in relation to the information they hold on their own health. It recommended that health care professionals training and development should place due emphasis on the need to give patients appropriate feedback on their conditions.
The Officials acknowledged the Committee's point that none of the ICT bids had been prompted by the need to provide a system that would facilitate feedback to a patient, and they undertook to bear this in mind for future bids.

• Causeway Trust: dementia services centre of excellence - the costs would be shared with the Department for Social Development.
• Extended Nurse Prescribing - to train a further 40 nurses in both 2002/03 and 2003/04. The Officials confirmed that the Department would be shortly producing an ICT strategy, of which a key aspect will be prescribing costs and the control of prescribing. The Committee was of the view that clinical practice and governance in primary care should be regularly revalidated and tested.

Agreed: The Chairman will write to the Chief Executives of the four HSS Boards to ask what measures are in place to control and safeguard against GPs over-prescribing, notwithstanding the fact that they are independent contractors.

• Hospital Order Communication Management System
• HPSS-wide on-line e-recruitment scheme
• Improving the quality of care in the Ambulance Service - creating a new echelon of health care worker in the paramedic profession. The Department will provide details of the new standards to which paramedics are to be trained.
• Belfast City Hospital: installation of PET and Cyclotron facilities. This proposal would put Northern Ireland at the forefront of fundamental aspects of clinical cancer treatment and research.

In relation to the new Cancer Centre, the Committee expressed its deep concern that the Department of Finance and Personnel and OFMDFM were still considering the Department's Infrastructure Fund bid for the new Centre and that it had not been passed to the Executive for a decision. An early decision is vital for work on the new building to commence.

Agreed: The Chairman will write to OFMDFM to express the Committee's grave concern at the delay in processing the Department's Executive Programme Fund bid in relation to the Cancer Centre and to request that it be passed to the Executive forthwith for ratification, given the urgency for the regional facility.

• School of Dentistry: Equipment and Sterilisation Facilities
• Drug and alcohol policies: assessing and addressing the problem
• Electronic care records: care data viewer - this project would develop a simple electronic 'web browser' that would initially allow access to data held in multiple systems within a single Trust.
• Electronic portfolios for continuing professional development
• Electronic case records for neurology and teleneurology - this can reduce length of hospital stay, provide more prompt diagnosis, reduce waiting lists and give easier access.
• Health Estates Agency's Intranet Estate Information System
• School of Dentistry: ICT Modernisation
• Improved public safety post-September 11th: equipment for NI Fire Brigade
• School of Dentistry: Extension of Certain Clinical Facilities - to address some of the issues relating to constraints on capacity and inefficiencies by improving facilities in the orthodontic clinic (which has been the subject of an adverse report) and procedure unit. The Department undertook to provide the Committee with more details on the bid, including a copy of the report from the Special Advisory Committee that had identified inefficiencies in the orthodontic clinic.

Social Inclusion/Community Regeneration Fund
The Department is submitting bids totalling £14.17m, which is 64% of the total amount available. The bids are summarised as follows:

• Investing for Health - 'health promoting workplaces and hospitals' and weakening the link between poverty and ill health.
• Bridging schemes for Mental Health and Learning Disability/Community Care - to help support people leaving institutional care settings and redeploy the savings from the closure of wards to fund the care support teams. The Committee welcomed the proposal to put in place in each Trust area a team of district nurses and therapists that would co-ordinate the good practices from Hospital at Home schemes. Major savings could be made in the acute hospital settings with the introduction of such schemes to help maintain people in the community setting and reduce the need for long-term institutional care. In this context, the Committee was surprised that the actual bid was not for a higher amount than the £2.15m over the period 2002/03 to 2003/04.
• Investing for Health - Support for local community health improvement projects
• Drugs and alcohol public information campaigns
• Mental health survey
• Responding to Domestic Violence - Time-bound Area Support Team
• Public outreach and engagement programme: Ambulance Service and NI Fire Brigade - targeting children and young people and training emergency staff in dealing with confrontation.
• Southern HSS Board pilot programme responding to needs of Travellers and their children
• Pilot study of feasibility of collecting equality information from service users at point of service delivery
• Research programme to support the new TSN and public health agenda
• Providing core diversity awareness training for HPSS professionals - with a view to its becoming an integral part of their training
• Reducing oral health inequalities for people with special needs
  
  Children's Fund
  
• Enhanced Training and Support for Foster Carers
• Early Intervention Project in the Eastern HSS Board targeted at primary school children with behavioural problems
• Family Centre in the Northern HSS Board - to support children with their families and reduce the demand for more expensive specialist services
• Family Group Conferencing in the Northern HSS Board - The Committee expressed concern that Northern Ireland did not currently have Family Group Conferencing given the well-documented problems with children and young people, particularly in interface areas in Belfast.
  
  The Committee strongly welcomed the bids for pilot projects in respect of preventive measures that would provide family support and reduce the numbers of children entering the care system, including the significant associated costs. The Officials advised that, in light of the evaluation process, there might be potential to mainstream or realign funding for pilot projects that proved particularly beneficial.
  
  
• Key Worker for Children with a Disability
• Replacement of Secure Accommodation at Lakewood - a report from SSI has indicated that the present provision is inappropriate
• Adopting Best Care - enhance the quality of adoption services - "Get registered with a Dentist" Campaign
• "Time Out" for looked after children, particularly those in residential care - pilot project in the Southern HSS Board area
• Addressing the health needs of looked after children
• Support for Young Carers - Development of multi-agency group in the Southern HSS Board area to co-ordinate work with young carers
• Upgraded Information Systems for NI Guardian ad Litem Agency
• Private Fostering
• Community Safety Programme - Western HSS Board area to divert young people involved in or at risk of involvement in criminal or anti-social behaviour

The Department undertook to provide the Committee with more detailed information on the Children's Fund bids as soon as possible, including the numbers of children privately fostered.

2. Health and Personal Social Services Bill - Draft Report

The Committee deliberated.

Draft Report on The Health and Personal Social Services Bill (NIA 06/01), proposed by the Chairman, brought up and read.

Ordered: That the draft Report be read a second time, paragraph by paragraph.

Paragraphs 1 to 24 read and agreed to.

Resolved: That the Report be the Third Report of the Committee to the Assembly.

That the Report should include written and oral evidence from the following witnesses:
Age Concern (Oral Evidence)
Belfast Carers Centre
Down Lisburn Health and Social Services Trust (Written Evidence)
Eastern Health and Social Services Board (Written Evidence)
National Board for Nursing, Midwifery and Health Visiting (Northern Ireland) (Written Evidence)
Prof. Robert Stout, School of Medicine, Geriatric Medicine, Queen's University Belfast
Registered Nursing Home Association (Written Evidence)
Sperrin Lakeland Health and Social Care Trust (Written Evidence)
The Department of Health, Social Services and Public Safety (Oral Evidence)
The (Shadow) Northern Ireland Practice and Education Council for Nursing and Midwifery (Oral Evidence)

Resolved: That the Report be printed.

3. Date and Time of the Next Meeting

The next meeting will be at 2:00 pm on Wednesday, 12 June 2002 in Room 135, Parliament Buildings.

The meeting ended at 2.00 pm.

DR J HENDRON
COMMITTEE CHAIRMAN

June 2002