Mr Gallagher (Deputy Chairperson)
Ms Armitage
Mr Berry
Ms Ramsey
Mr Hamilton

Ms P Blaney ) Northern Ireland Practice and
Ms M Griffiths ) Education Council (NIPEC)

I should like to welcome Ms Paddie Blaney and Ms Maureen Griffiths from the Northern Ireland Practice and Education Council (NIPEC). Perhaps you will start with a short presentation, after which we shall proceed to questions.

The main role and function of the NIPEC is to support nurses, midwives and health visitors in their education and practice. Its ultimate aim is to provide better patient care. Through supporting the profession it provides better care for patients, families and communities. Appointments to the council were made through an open selection process. I applied and was appointed as chairperson. Afterwards there was an open selection process to appoint members of the council. Although we did not state in our advertisements that we wished to have a midwife or health visitor, we took care to satisfy ourselves that each sector of practice was represented in some way. We were looking for a mix - 60% professional and 40% lay people - and we have been able to achieve that balance in the applications which we have received. We are happy to have a strong council. Our approach has been to retain one or two places so that we can identify any gaps which need filling in NIPEC's early months.

Thank you for the opportunity to speak to the Committee. I have a foot in both camps, as I am still a nursing officer in the Department, and next week I become chief executive designate of the shadow NIPEC, which has the status of an advisory body.

The role and aim of the NIPEC have come together through three main factors. The first factor was that, about four and a half years ago, we reviewed legislation regulating nurses, midwives and health visitors across the UK. I know about it because it was largely part of my remit; it achieved final fruition on 1 April 2002. We have established a UK-wide regulatory body for nurses and midwives which registers them and ensures that good conduct is maintained. The legislation meant that we lost the national board for Northern Ireland - which was largely an education quality-assurance body - and it was replaced by the Nursing and Midwifery Council (NMC).

The second main factor was devolution. It was happening in Wales, Scotland and Northern Ireland, and all those countries were examining their devolved health and education systems to find out what they required to support the professions. Each country has gone for a similar body, though ours is slightly broader functionally.

The third area of dynamism at the time was clinical and social care governance, concerned with quality, better partnerships, more accountability and the importance of professionals remaining up to date and safe to practise. Along with the development of the An Bord Altranais, our sister regulatory body and national council in the Republic, that gave us an opportunity to examine what we need in Northern Ireland to support the development of nursing and midwifery. We must support that because of the huge changes in roles.

Nurses work in criminal courts, schools and industry. They also work with clients in clinics and on the streets. It was recognised that a body could be established to support the development of nurses and midwives in a more local fashion. That is the historical background and rationale to the establishment of the NIPEC. I am delighted to have been given the role of chief executive designate, but I have yet to take it up full time. When I take up that role, the focus of our work will be on education, practice development and performance.

The difference in our body lies in its broader functions. It is not simply concerned with education; there is much more lay involvement. As Ms Griffiths said, 40% of the council's representatives are lay people, and that will bring a wonderful dynamic to the NIPEC. That is a broad interpretation of our role, and I am happy to take more detailed questions.

Thank you for your presentation. Ms Griffiths said that each sector should be represented in some way. How are midwives represented?

We have appointed a midwife as an educationalist. I am also a midwife, albeit non-practising. Ms Blaney made a point about practising midwives. There is a midwifery focus, and the opportunity existed for practising midwives to apply in open competition. Although that did not happen on this occasion, I stress that there is no bar to such applications. The same applied to health visitors, among whose number I count myself. There are ways of bringing those perspectives to the work of the council.

Since you wish to see each sector represented, would automatic places for practising midwives and others, rather than nominations from the Department, not be the best way to achieve that?

A great deal of thought went into the matter. What do you mean by nominations from the Department?

The midwives said:

"We are concerned, however, that it is proposed that all nominations to the board should be made by the Department of Health, Social Services and Public Safety."

Would you not feel more content that everyone was properly represented if midwives had a right to a place?

As I have explained, appointments were not made through a nomination process but through open competition. The Nolan principles were applied. Since we wished a balance of 60% professionals and 40% lay people on a council of between 10 and 16 members, we could have representatives from mental health, learning disability and all the different specialisations.

On reflection, we did not consider it the best route to take; we felt it would be better to have an open competition and get the best candidates. Thereafter there would be other ways of working through expert panels, so that, if the council had to discuss a midwifery issue, I could have midwifery input. The remit of my other position also covers midwifery. I commission midwifery services, so there will be no ignorance of such issues. The council will have an educationalist with a strong midwifery background, and we shall also be able to draw on experts from the sector. The same will apply to health visiting and learning disability if they are not represented.

Are you saying that the Royal College of Midwives (RCM) was incorrect when it said:

"We are concerned, however, that it is proposed that all nominations to the board should be made by the Department of Health, Social Services and Public Safety."?

That is expressed incorrectly. There were no direct appointments; an open competition and interviews decided the composition.

That would suggest that we are talking not about what has happened, but about what is proposed.

They are incorrect, as I shall try to explain. I believe that the RCM is concerned about nominations at this stage. It is incorrect, since we did not nominate, and neither did the Department. The Department advertised under the Nolan principles and conducted interviews to determine the body's composition.

You are telling us what happened to put you and the rest there.

No, it was to put the council in place.

Put the council in place?

Council members have been interviewed and have only just received letters of appointment. A press release will be made later this week or next. There is a hiatus there to explain this properly. The Minister has already given her approval for the composition of the panel drawn from the nominations. That is probably where the misunderstanding arose.

So there is no proposal that future nominations be made by the Department?

Not to the best of my knowledge. Any future council would be recruited under the normal procedures for appointing non-departmental public bodies - open advertisement under the Nolan principles and competition decided on that basis.

The document appears to discuss what will happen in future.

We are not aware of that.

I merely wish to be clear about the matter.

We can return to it when we go into detail on the clauses with the Department.

I am certainly sympathetic to any sector of nursing which feels that the NIPEC should represent it. As chief executive, I am conscious that it is equally important that women with children feel that the NIPEC has something to offer them. It has been a delicate balance, and we shall "suck it and see". We shall have some latitude on numbers when the NIPEC is established and sets to work. If we see any gap, we can certainly work to fill it.

If we are concerned, should this be removed?

I am not sure of the status of the paper to which you refer.

It is merely a submission on behalf of the Royal College of Midwives. At this stage it is a submission, and we shall go back to the departmental officials. At present we are taking submissions from other interested parties in preparation for the final stages of the Bill.

We can correct that and give you a fuller picture.

I am not claiming to speak for the RCM, but, although the advertisement is to be open, the college's concern is with the criteria put in place by the Department, which appoints people to the board. It might be open, and 100,000 people might apply for it, but criteria are in place, and it is a departmental appointment. My concern is to clarify that. Although it is open and accountable, it is still the Department's selection.

I cannot talk about the specific process, as I was not involved. However, I can assure you that the criteria were set to find those who would contribute the most personally, as opposed to narrower criteria which would have disadvantaged midwives.

I understand that, but my concern is whether the proper criteria are in place. I take on board the point you made that 40% of the council are lay members; that is commendable. We do not want to set up another quango made up of the great and good. I should like to see a copy of the criteria in place by the time the Minister makes appointments. It is not a question of whether people are applying, but of whether they get the job.

I mean in general. As a layperson I can -

- anybody who is appointed to the council.

The application criteria in the advertisement were very open.

We can find out more about the matter from the Department.

Few people have any problem with the Bill generally. In your presentation you said that, given the council's work, there may be a need to co-opt others who do not currently sit on it. I sit on several groups which allow the co-opting of those working in the mental health field. Can your organisation solve that problem? Can free places be set aside to co-opt a nominated representative?

Places on the council can be set aside. We also propose allowing secondments for particular pieces of work. There will be project work which midwives could, where relevant, feed into. We hope to establish expert panels for education and practice development which will offer different levels of opportunity for active involvement by any practitioner, nurse, midwife or health visitor.

The arrangements are flexible and should be dynamic rather than static.

Will the Bill's provisions meet all the council's needs? Do you feel that there might be a time when you have to revisit it?

I asked Breedagh Hughes of the Royal College of Nursing (RCN) about the database, and you will be aware of my concerns on the question. We have been told that it is proposed that the NIPEC retain a database on qualifications and training.

As a nursing officer, my remit covers areas related to the Bill. The project director whom the Department appointed is here today. We hope that the structure will enable the NIPEC to support the development of nurses proactively to improve care. I cannot see any major loopholes in the Bill; it is enabling legislation, and I am sufficiently comfortable that we shall be able to deal with it.

There are two issues to be clarified about the database. The NMC, which is now the UK-wide regulatory body, will continue to maintain a register. A person's name must appear on that register to allow him/her to practise as a nurse and midwife. That will continue and will be simplified. Nothing will change. The name of every nurse, midwife, health visitor, mental health nurse, learning disability nurse and children's nurse in Northern Ireland must be on that register to allow him/her to practise. It is a public safety and regulatory issue.

There is some confusion about the NIPEC database. Previously, the national board held an indexing database, whereby any student entering training was indexed and tracked through it. At the end of three years' training, the national board told the United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) that the student could be entered on the register. The NMC has put new arrangements in place to do that electronically together with all the universities in England, Scotland, Wales and Northern Ireland, so an indexing database is no longer required here to register people.

The NIPEC will need to develop databases which support its work; for example, databases of practice development work. There has been the old syndrome of brilliant work being done in one area without the sister in the next ward or trust knowing about it. There will certainly be information needs and database developments. They will not be at an individual level but will be maintained by the NMC. That is also a public safety issue.

The NIPEC's database is functional.

Thank you very much for your submission. It has been very helpful.

17 April 2002 (iii) /Menu / 1 May 2002