Present: Dr J Hendron (Chairman)
Ms P Armitage
Mr P Berry
Mr J Kelly
Ms M McWilliams
Ms S Ramsey
Mrs I Robinson

Apologies: Rev R Coulter
Mrs A Courtney
Mr T Gallagher (Deputy Chairman)

In Attendance: Mr P Hughes (Committee Clerk)
Mr D Harkin (Assistant Clerk)
Mr D Gordon (Executive Support)
Mr B Greene (Administrative Support)
Mr M Norman (Administrative Support)
Mr Chris Thomas (NHS Management Trainee)

i. Agreed: The Committee will observe one minute's silence at 1.46pm in respect of the victims of the terrorist attack on New York City on 11 September 2001.

ii. Agreed: The Committee will take up the offer of a presentation by Extra Care at its office in Wellington Park on its work to provide domiciliary care for the elderly, their carers and their families. The Clerk will arrange a mutually convenient date.

iii. The Chairman reported briefly on his attendance at the launch of the new Positron Emission Tomography (PET) scanner at the Royal Victoria Hospital today. He warmly welcomed the scanner as a significant technological advancement, which will be vital in the future treatment of cancers and cardiac disease. He praised the work of a number of charities in purchasing the scanner and funding its first two years running costs. However, he expressed regret that, due to budget limitations and expensive revenue costs, the scanner would initially only be operational for one day per week.

Agreed: The Chairman will write to the Minister welcoming the introduction of the scanner and adding the Committee's full support for the Department's bid under Executive Programme Funds for funding to extend the operational capacity of the scanner to its optimum level.

iv. Agreed: The Committee will accede to a request by the Northern Ireland Lymphodema Society for an informal lunchtime meeting. The Clerk will arrange a suitable slot in the forward work programme.

The Committee observed one minute's silence at 1.46pm in respect of the victims of 11 September.

2. Minutes of Proceedings of the Last Meeting

The minutes of the meeting of 04 September 2002 were agreed.

3.Matters Arising

i. Agreed: The Committee agreed, as amended, the draft response to the Executive Position Report on the Draft Programme for Government. Mrs Robinson requested that her dissension be noted in respect of the reference that health and social care should be the Executive's "prime objective" as opposed to one of its priority objectives.

4. Subordinate Legislation

i. Food (Peanuts from China) (Emergency Control) Regulations (Northern Ireland) 2002

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

Ms Ramsey joined the meeting at 2.15pm.

ii. Fire Services (Appointment and Promotion) (Amendment) Regulations 2002

The Chairman reminded members of the intention of the proposed statutory rule, which is to widen the pool of qualified potential applicants for the post of Chief Fire Officer beyond the UK. The aim was to attract the strongest possible field of candidates. He also referred to the advice of the Assembly's Legal Service in respect of the aim of the Regulations, which was that "the retention of the existing qualification requirements for Chief Fire Officer probably cannot be justified, particularly in light of a relaxation of nationality requirements for public service posts". The Chairman also noted that, at the last meeting, some members had observed that the legal advice was couched in general terms, by advising that the current 1989 regulations "probably" contravene the application of EU law by, in effect, reserving posts to UK nationals. Those members had made the point that counter legal arguments could equally be mounted.

Following a number of concerns raised at last week's meeting the Committee had agreed to a presentation by the Fire Brigade Union on its concerns about the proposal.

Fire Brigade Union Representatives: Mr Jim Hughes
Mr Tom Wright

Mr Hughes voiced concern that the Fire Authority had not consulted with the Fire Brigade Union in relation to the proposal. He expressed surprise at the proposed legislative change given that the Fire Authority had signed up to the national Integrated Personal Development System, which provides for a seamless progression from the recruit stage to Chief Fire Officer (CFO) post. He emphasized the importance of the CFO's having the command and respect of the entire firefighting force. Mr Hughes argued that there would be a serious loss of morale among the members if they did not have confidence in the competence of the CFO.

Mr Hughes underlined that the sole concern of the union was to ensure that the CFO has the ability and necessary training to do the job. Mr Hughes conveyed the union's lack of conviction that the new proposals to introduce a two-tier entry system would ensure that the most suitable person would fill the post. It was the belief of the union that completion of the highly respected Brigade Command Course should be a prerequisite for senior officers aspiring to the highest positions of command. The officials also queried why similar legislative changes were not being proposed in respect of the 58 Fire Brigades in GB, in order to address issues of equality.

Mr Wright advised that it was the union's belief that the CFO's post in Northern Ireland, together with the Fire Commissioner's post in the London Fire and Civil Defence Authority, are designated under Article 44 of the Treaty of Rome as being exempt from the freedom of movement legislation within the European Community (EC).

Departmental Official: Mr Denis McMahon

Mr McMahon reiterated the Department's view that the proposed legislation would provide for the strongest possible field of candidates, and that it was based on the promotion of equality. He emphasized that the proposal would not preclude any existing candidates from Northern Ireland or GB from applying for, or being successful in, the competition. He stated that the current regulations could be seen as discriminating against non-UK nationals by, in effect, unnecessarily reserving posts to UK nationals. The legal advice to the Department is that any such challenge to the regulations could be successful. Mr McMahon confirmed that HM Inspector of Fire Services would be advising on the equivalence of qualifications to officers who have passed through the ranks of the Northern Ireland Fire Service. He undertook to check on the details and timing of the Department's consultation process with the Fire Brigade Union on the proposal.

Agreed: The Clerk will write to the Department to request clarification on the meaning of "equivalent qualifications" to a person who has served in the rank of Divisional Officer (Grade 1) and completed the Brigade Command Course, as referred to in paragraph 2 (1) (b) of the proposed statutory rule. He will also request details of the criteria under which certain public sector posts are designated under Article 44 of the Treaty of Rome as being exempted from the freedom of movement legislation within the EC, and the legal basis for not treating the post of CFO as satisfying the exemption provisions.

Officials: Mr Clive Gowdy, Permanent Secretary
Mr Don Hill, Deputy Secretary
Mr Paul Simpson, Deputy Secretary

Mr Gowdy spoke to a briefing paper on the Department's Work Programme, covering the main issues to be addressed in the lead-up to the Assembly's dissolution. Its key features include:

• Acute Hospitals Review
• The location of the Regional Maternity Hospital
• Programme for Government III
• Budget Process/Executive Programme Funds
• Waiting Lists
• Firefighters' Pay
• Review of Cardiology, Renal Services, Trauma Services and Mental Health policy
• Legislative programme
• Extension of nurse prescribing

Mr Gowdy advised that health would need a Budget increase of 11% next year just to maintain the existing level of services. He explained that the output of the Needs and Effectiveness Evaluation study, which confirmed substantial underfunding of health services, would be an important tool in support of the Department's Budget bid for 2003/04. He also pointed out that the study confirmed that the efficiency and effectiveness of the Health Service was not in doubt.

In response to a question by Mr Berry on the timescale for a final decision on the acute hospitals review, Mr Gowdy advised that the Department was keen to have a decision made by the year end and aimed to publish implementation plans to give effect to the proposals at that time. The proposals would be subject to approval by the Executive.

On a further query by Mr Berry on waiting lists, Mr Gowdy emphasized that this continued to be a priority issue for the Minister. A Waiting Lists Co-ordinator, Ms Gillian Anderson, has been recently appointed to examine how improvements can be made. He cautioned that there would not be a short-term solution but that it would be necessary to build up capacity and make investments in information systems. To this end, he drew attention to plans for 100 additional beds in the Mater, Craigavon and Antrim Area Hospitals, a day procedure unit at the Erne Hospital and new modular theatres at Musgrave Park Hospital. He also urged members to look beyond the headline figures, as 1,000 more patients had been treated in the last quarter, while the increase in overall numbers waiting was smaller than before. The increase in the number of emergency admissions has had an effect on the ability to deliver on elective surgery. Mr Gowdy acknowledged the problems created by cancellation of appointments and advised that this was an issue being addressed by the Regional Improvement Leader in her review of waiting lists. He also undertook to provide details of latest statistics on appointment cancellations.

In response to Mrs Robinson's concern about the implementation of the Local Health and Social Care Groups, Mr Gowdy confirmed that, in accordance with the advice of the BMA, GPs had not taken up their seats on the Groups. The other primary care professionals were doing useful work on the Groups in relation to winter planning issues.

Ms McWilliams raised concern at the overcrowding problem at the Royal Jubilee Maternity Hospital and the delay in a decision on the siting of the Regional Maternity Hospital. Mr Simpson undertook to meet with the Chief Executive of the Royal Group of Hospitals on the matter and respond to the Committee. He confirmed that this was a matter that would require immediate attention as, even after a decision on the siting of the Regional Maternity Hospital was reached, there would be a further lead-in period for its funding, design and construction.

Ms Ramsey voiced concern at Mr Hill's revelation that the Department's bids for additional resources for information technology had been rejected under the Executive Programme Funds. This was seen as particularly disappointing given the Committee's recommendation in its recent report on cancer services for the urgent development of a co-ordinated information management solution for health services. There is clear evidence to suggest that the current systems are often poorly developed and incompatible, which impacts adversely on patient outcomes. The Officials undertook to provide the Committee with more detail on the bids rejected.

Mr Simpson confirmed that plans are well advanced to extend nurse-prescribing rights to a wider group of nurses from a much extended formulary. This should benefit patients by enabling faster access to care by making better use of nurses' knowledge and skills.

Officials: Mr Don Hill, Deputy Secretary
Mr Denis McMahon

The Officials briefed members on the background to the pay dispute between the Fire Brigades Union (FBU) and Employers representing both GB and Northern Ireland. They confirmed that the Fire Brigade Union had rejected the offer of a 4% interim pay increase, a review of the current pay formula, and an independent review to examine the Union's demand for a £30,000 basic salary for firefighters. The FBU will reconvene their annual conference on 12 September to consider balloting their members on strike action.

Mr Hill emphasized the Department's hope that industrial action will not occur. However, he confirmed that given the potential risk to life and property in such a situation, contingency arrangements were being put in place. The Department will continue to liaise closely with the Fire Authority in the coming weeks to ensure that the necessary arrangements are in place. He cautioned that, although the cover should be sufficient to deal with most situations, there would inevitably be an impact in terms of the speed and level of response. Only one third of the current cover would be available. All calls would be prioritised under the guidance of a fire officer from the Fire Authority in terms of risk to life followed by risk to property.

Agreed: Members agreed the draft letter to the Deputy Prime Minister expressing the Committee's unanimous support for a fair pay settlement for firefighters and control staff. A draft press release was also agreed highlighting the Committee's support for the Union's call for a fair wage.

NSPCC: Mr Ian Elliott
Mr Colin Reid

Mr Elliott spoke to a briefing paper, which posed a number of questions about the policy intent of the Bill, as well as some technical queries. This was followed by a question-and-answer session. The entire proceedings are reported separately in verbatim minutes of evidence. The main issues raised are summarised as follows:

• The need to ensure that accreditation of voluntary organisations is supported by other government departments;
• A recommendation to waive the imposition of fees for smaller groups dependent on the use of volunteers both for accreditation and in access to the Register (as announced by the Home Office and Scottish Executive in similar legislation);
• The need for adequate all-island systems of suitability checking and how this is being taken forward with the Department of Health and Children in the Republic of Ireland;
• A recommendation for the establishment of a small reference group with expertise to assist the Department in examining potential individuals for listing against the criteria to be used under clause;
• A warm welcome for the development of a PECS awareness group to provide information to parents;
• There is an urgent need to alert and educate the public about the limits of the Bill. For example, it does not cover self-employed entertainers or non-registered child minders employed in parents' own homes;
• A recommendation for a minor amendment to clause 17 to allow organisations to whistleblow on other bodies when they are aware that the requirements in clause 2 are not being fulfilled;
• Recommendation to seek the urgent enactment of Part V of the Police Act 1997, which allows for the provision of "soft" police intelligence in an enhanced criminal record check, which is required for work with children.

Mr Reid pointed out that the absence of a consultancy index in ROI is a major flaw in the system. Another problem is that the Criminal Record Bureau in England is not checking the Department's list and so is not implementing fully the legislation across the UK.

Agreed: The Chairman will write to OFMDFM to request that the issue of cross-jurisdictional vetting in relation to work with children be taken up with the British-Irish Council.

The Children's Law Centre: Ms Tara Caul

Ms Caul briefed the Committee on the main issues for the Children's Law Centre arising from the Bill. These included:

• the importance of proactive implementation of any accreditation scheme the raising of public awareness
• the need for adequate all-island systems of checking
• a recommendation that, through a wider definition of "childcare organisation", all groups that have regular contact with children be obliged to carry out checks. This should include institutions within the criminal justice system
• a recommendation that the definition of "childcare position" be widened to include reference to children in juvenile justice centres and those working with them
• the need for clarification as to reason for the exclusion in clause 29 (4) of children in respect of children in employment
• recommend that clause 29 (1) ( c ) is amended to include the words "advising and counselling"
• recommend that accreditation be a mandatory requirement for groups that have post-holders who are in regular contact with children
• it is important to have further consultation about any further regulations by the Dept of Education, including the respective standards of proof that exist between the Departments.

The independent schools do not appear to be covered by the Bill or the education regulations. (In response to a query by Ms McWilliams, Ms Caul undertook to ascertain whether amendments were put down in relation to this matter when similar legislation was being passed in England.) Non teaching staff in further education colleges may not be currently covered.

• Part V of the Police Act and the establishment of a Criminal Records Bureau should be expedited.

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

The meeting was suspended at 4.15pm and resumed at 4.25pm.

8. Inquiry into Child Protection Services - Briefing by Specialist Adviser

The Chairman welcomed Mr David Spicer, Specialist Adviser to the Committee's Inquiry in to Child Protection Services in Northern Ireland, and wished him well in his work with the Committee. Mr Spicer briefed members on the main themes arising from the 50-odd written submissions received to date and his own observations as an expert in the study of child abuse. These are summarised as follows:

• There is clear misconception among respondents that child protection is everyone's responsibility. Within the legislation, however, it is not a community responsibility - it rests with the Trusts and is delegated down to social services.
• The submissions do not call for wholesale changes to the present child protection structures, perhaps with the knowledge that such times of massive upheaval can be very dangerous for vulnerable children.
• There is a clear statement that communication needs to improve between professionals concerned with various services being delivered to children and families. It can be difficult to actually implement measures to improve the sharing of information. This can be linked with a related issue, which is knowing what information ought to be shared. Ethical views in relation to confidentiality issues do impede the sharing of information. There should be no ambiguity as to what information can be shared between professionals.
• There is a question as to how much the public are made aware of child protection issues. Evidence suggests that, for the most part, they are unaware of the scope and nature of child abuse.
• The submissions indicate that there are good systems in place for monitoring and auditing performance.
• There is a growing perception that children who are involved in criminality and are in custody are an extremely vulnerable group who are receiving very poor services. They have intensive needs in terms of mental health.
• It would be very important for the Inquiry to reflect children's views of the way in which child protection services are being delivered.

The Clerk reminded members of the arguments by witnesses that lead to the Committee's decision to recommend the removal of clause 6. A number of statutory and voluntary bodies had expressed concern about the removal of entitlement to social security benefits to care leavers and the transfer of responsibility for their financial support to HSS Trusts. Several witnesses voiced concern that such a transfer of resources would further stigmatise young people leaving care. Some young people maintained that they would become dependent on their personal adviser for everything and this would affect their independence.

There was also a concern that in moving from social security to a cash-limited social services system, budget considerations could become the basis for decision-making rather than individual need. Concern was raised about how consistently financial packages would be delivered across different Trust areas, and also how the situation would be managed if the relationship between the care leaver and social services were to break down irretrievably.

The decision, on balance, to recommend the removal of clause 6 was strengthened by the absence of a cast-iron guarantee from the Department that all resources that would be transferred from the Department for Social Development would be defrayed exclusively in the support of care leavers. The Committee noted the contrast with the introduction of similar legislation in England, which was accompanied by a substantial ring-fenced additional budget.

Officials: Mr John Clarke
Mr David Magowan

Mr Clarke advised that the intention of the Bill was to promote the concept of continuing responsibility of a Trust and to assess and meet the needs of the young person in a holistic way. If resources deployed on benefits are not transferred to Trusts, the ongoing significance of the Trust in the young person's life will be weakened. This would be at odds with the intention of the Bill to support the concept of a continuity of responsibility for a young person looked after by social services which extends beyond the time the young person is looked after.

Mr Clarke explained that, in the event of the removal of clause 6 from the Bill, the Department would seek an amendment to clause 2 by removing the specific duty in Article 34C (8) for Trusts to maintain and accommodate "relevant children".

Some members raised concerns, upon refection, about the implications of the removal of clause 6, including the issue of parity with GB for the purposes of social security benefits. They were given some assurance on the funding issue by Mr Clarke, who emphasized the Department's position that, in line with the clear principle underpinning similar legislation in England and Wales, children and young people would not be any worse off as a result of the Bill.

Question put, That the Health, Social Services and Public Safety Committee is content with its recommendation to remove clause 6 from the Children (Leaving Care) Bill.

The Committee divided: Ayes 4, Noes 3

The Chairman undertook to reflect clearly in his opening remarks on the Consideration Stage of the Bill on Monday, 16 September the complex arguments surrounding Clause 6, as evidenced by the Committee's majority decision.

10. AOB

The Clerk reminded members of the meeting scheduled for Friday, 13 September 2002 in Room 135, Parliament Buildings with senior trade union and health service managers from New York City.

The next meeting will be at 2:00 pm on Wednesday, 18 September 2002 in Room 135, Parliament Buildings.

DR J HENDRON
COMMITTEE CHAIRMAN

September 2002

4 September 2002 / Menu / 18 September 2002