COMMITTEE FOR HEALTH, SOCIAL SERVICES AND PUBLIC SAFETY
Health and Social Care (Reform) Bill
23 October 2008
Members present for all or part of the proceedings:
Ms Sue Ramsey (Temporary Chairperson)
Mr Thomas Buchanan
Mr Alex Easton
Mr Tommy Gallagher
Mr Sam Gardiner
Mrs Carmel Hanna
Mr John McCallister
Mrs Claire McGill
Witnesses:
Mr Craig Allen )
Dr Carolyn Harper )
Mr Ivan McMaster ) Department of Health, Social Services and Public Safety
Mr Bernard Mitchell )
The Temporary Chairperson (Ms S Ramsey):
We now move on to the Committee’s formal clause-by-clause consideration of the Health and Social Care (Reform) Bill.
The Committee Clerk:
This is the Committee Stage of the Health and Social Care (Reform) Bill. The Committee must formally consider the Bill’s clauses and agree whether each clause, as it is drafted, should stand. In the past couple of weeks, members have raised concerns about several clauses. The Department agreed to consider whether the Committee’s proposals were acceptable. The Committee can decide to table any proposal that has been rejected by the Department as an amendment at the Bill’s Consideration Stage and include it in the report. It may be useful for the Committee to consider the acceptable clauses today and defer the others until the next meeting.
Mr Buchanan:
The Department has accepted some of the Committee’s proposals and rejected others. I ask that the clause-by-clause consideration is deferred until the next meeting so that the Committee has sufficient time to establish what the Department’s problems were with the proposals that it rejected.
Mrs McGill:
Are all the issues that the Committee raised — such as my point about equality — dealt with in the correspondence?
Mr Bernard Mitchell (Department of Health, Social Services and Public Safety):
To the best of our knowledge, the correspondence that has been provided to the Committee covers every point that was raised. We have highlighted a couple of additional items for the Committee’s attention. We have tried to ensure that the Department’s letter to the Committee, dated 22 October, is comprehensive and that there are no surprises for the Committee.
Mrs McGill:
Did we just get that letter now?
The Temporary Chairperson:
Yes, we did.
Let me clarify the situation. There are some clauses in the Bill that the Committee had concerns about and wished to amend. The Department has accepted some of those amendments and rejected others. The first suggestion is that we deal with the non-contentious clauses and defer the others until a later date. The other proposal is that we defer everything today.
Mr Gallagher:
I am happy to deal with the non-contentious clauses today.
The Temporary Chairperson:
We are under pressure to complete the Committee Stage of the Bill.
Mr Gardiner:
If that is the case, we should deal with the amendments that the Department has accepted and not hold the Bill back.
Mr Buchanan:
We have continuously raised the issue of the regional agency. I do not see anything on the list of recommendations from the Department that suggests that it has either accepted or rejected our proposal on that issue. I made the point very strongly that there was no need for such an agency and that its functions could be carried out by the regional board.
The Temporary Chairperson:
We will not even discuss that clause today, because it is contentious.
Mr Buchanan:
If I can have an assurance that the issue will be discussed at a later date, I will be happy to defer it today.
The Temporary Chairperson:
Bernard, I am suggesting that we deal with the non-contentious clauses.
Mrs McGill:
I raised several concerns about disability-related matters. Issues were raised by Disability Action, if I remember correctly. I have not had time to consider these amendments. I know that the Department has rejected some of them.
The Temporary Chairperson:
That is the Department’s job now. It will report back and let us know which amendments it has accepted or rejected.
Mrs McGill:
Is that in front of us? I see no point in a process in which a Department, or any Government body, asks organisations such as Disability Action to respond to a consultation, and a member of the Committee picks up on that response and raises it with departmental officials. A paper then comes before me, but I cannot see what the situation is; it is too rushed for me. Such a paper might be brilliant, but I do not see any point in asking organisations such as Disability Action for their views. I mention Disability Action only because I remember raising a couple of points about disability and equality.
The Temporary Chairperson:
Let me just clear things up for the record. Several concerns have been raised in the past few weeks by members of the Committee and by respondents to the consultation. What we now propose to do is deal with the amendments that the Department has accepted. The amendments that have been rejected by the Department will not be dealt with today. We will defer discussion of those amendments.
Mr Mitchell:
I will clarify things from our perspective. We were asked to present a separate paper with some additional facts on the issue of the regional agency. We have done that. It is not that we are trying to avoid the issue.
We expect that to be discussed under the heading of the separate paper. The issues from Disability Action to which you are referring are issues that we have not accepted, so they would be deferred for discussion at a later date.
Where the Department has not accepted recommendations, generally — not exclusively — the only two reasons for rejection are because the draftsman has told us that he thinks that there are difficulties with the form of wording that is being proposed or that the issue is covered by other legislation, and, consequently, we think that it would result in duplication if it were to be included in the Health and Social Care (Reform) Bill. I am happy that we get the chance to discuss those points one by one, including the issue of the agency.
Clause 1 (Restructuring of administration of health and social care )
The Temporary Chairperson:
Issues were raised about clause 1; the Department has rejected one of the Committee’s recommendations.
Mr Ivan McMaster (Department of Health, Social Services and Public Safety):
There were two issues about clause 1. The suggestion that the agency be called the “health and social care RQIA” has been rejected; the suggestion that the acronym RAPHSW is unwieldy and should be altered has been accepted. May we refer the clause?
Clause 1 referred for further consideration.
Clauses 2 and 3 agreed to.
Clause 4 (Department’s priorities and objectives)
The Temporary Chairperson:
It was suggested that the word “extreme” be inserted before “urgency”, and the Department’s recommendation is that it be rejected.
Clause 4 referred for further consideration.
Clause 5 (The framework document)
Mr McMaster:
The existing wording in clause 5(5)(b) is that the Department “ may consult”, but the suggestion was made that the wording be changed to the Department “will consult”. The Department accepts that.
Mr Gallagher:
Does this clause refer only to the Department?
Mr McMaster:
Yes, it does. The Department:
“may consult any other bodies or persons the Department considers appropriate.”
The suggestion was that “may” should be changed to “will”, and we accept that.
Mr Gallagher:
At some point, I raised concern about the trusts’ duty to consult with the users. Is that something that comes up in the regulations?
Mr Mitchell:
There is a legislative requirement for all the bodies to produce a consultation scheme that indicates how they would consult with service users and other stakeholders. That is provided for.
Mr Gallagher:
It would be useful to know where that is.
Mr Mitchell:
That is in clause 20.
Mr McMaster:
There are issues to be raised when we get to that clause.
Mr Gallagher:
We can leave those issues until we reach that stage in consideration.
The Temporary Chairperson:
The Department has agreed to accept the recommendation from the Committee.
Question, That the Committee is content with the clause, subject to the Committee being satisfied with the wording of the Department’s proposed amendment, put and agreed to.
Clause 5, subject to the Committee being content with the wording of the Department’s proposed amendment, agreed to.
Clause 6 referred for further consideration.
Clause 7 agreed to.
Clause 8 ( Functions of the Regional Board)
The Temporary Chairperson:
During previous discussions, members were otherwise content with this clause as drafted, but there was an issue about the Minister’s views on joint sign-off.
Mr Mitchell:
The Department was keen to ensure that there will be no surprises for members when the Bill is presented. The Department has stated a couple of times that it is considering a joint sign-off. The fact that that was happening was merely being put on the record, and a form of words was being sought on the issue.
Clause 8 referred for further consideration.
Clause 9 ( Local Commissioning Groups)
The Temporary Chairperson:
Members were concerned about the wording of clause 9(4)(b)(i), which states that the groups must:
“consult RAPHSW and have due regard to any advice or information provided by it”.
Officials had agreed to consider a call from the Royal College of Nursing (RCN) to strengthen that provision. The Department is recommending that the Committee accepts clause 9(4)(b)(i) with an amended form of wording. Bernard, will you explain that?
Mr Mitchell:
Michelle O’Neill presented, on behalf of the RCN, a form of wording that included what, for me, was the most important part — that local commissioning groups must work in partnership with the regional agency. The Department has consulted with the legislative draftsman, and a form of words has been produced that I hope addresses that point while at the same time embracing the requirement to have due regard to the advice and information provided by the agency. In all fairness, since the point was raised by Michelle, the Committee may wish to consider her view on that.
Clause 9 referred for further consideration.
Clauses 10 and 11 agreed to.
Clause 12 (The Regional Agency for Public Health and Social Well-being)
The Temporary Chairperson:
Is Thomas Buchanan not here? The Committee should slide in clause 12 while he is not here. [Laughter.] I am joking.
Mr Gardiner:
Will that be done on the Temporary Chairperson’s recommendation? [Laughter.]
Clause 12 referred for further consideration.
Clause 13( Functions of RAPHSW)
The Temporary Chairperson:
During previous discussions, members raised questions about clause 13(2)(b) — health promotion — and suggested that a new provision be included in clause 13(4)(e), which requires that the RAPHSW:
“make available to any other body such persons, materials and facilities as it thinks appropriate”.
The Department has agreed to accept that, in relation to clause 13(2)(b), officials will suggest a wording along the following lines to the legislative draftsmen:
“the health promotion function is the process of enabling people to increase control over, and to improve, their health and social well-being”.
However, the Department rejected a suggestion to include the words:
“including the Assembly Health, Social Services and Public Safety Committee”
after the words “any body” in clause 13(4)(e), which states that the RAPHSW may:
“make available to any other body such persons, materials and facilities as it thinks appropriate”.
Clause 13 referred for further consideration.
Clause 14(The Regional Support Services Organisation)
The Temporary Chairperson:
Members were content with clause 14 and its related schedule, apart from the name of the proposed body, which the Committee wants to call the “regional business services organisation”. The Department’s response is that it would consider a change in the name of the organisation to the “regional business support organisation”.
The Committee Clerk:
The current name used in the Bill is the “regional support services organisation”; the suggestion from the Committee was “regional business services organisation”.
Mr Mitchell:
The Department accepts that suggestion.
The Committee Clerk:
I am sorry, your letter of response states that the Department will accept the name “regional business support organisation”?
Mr Mitchell:
That is a typo. It should read “regional business services organisation”.
The Temporary Chairperson:
So we were right.
Mr Mitchell:
You were right, and we were wrong.
Question, That the Committee is content with the clause, subject to the Committee being satisfied with the wording of the Department’s proposed amendment, put and agreed to.
Clause 14, subject to the Committee being content with the wording of the Department’s proposed amendment, agreed to.
Clause 15 (Functions of RSSO)
The Temporary Chairperson:
The wording of clause 15(3)(a) was mentioned last week. It relates to the inclusion of the word “equitable” alongside “economic, efficient and effective”.
Clause 15 referred for further consideration.
Clause 16 agreed to.
Clause 17 (Functions of the Patient and Client Council)
The Temporary Chairperson:
During previous discussions, members highlighted the concerns raised by Disability Action relating to the clause.
Clause 17 referred for further consideration.
Clause 18 (Duty to co-operate with the Patient and Client Council)
The Temporary Chairperson:
The officials agreed to consider the recommendations, and they have accepted our suggestion to change “have regard to” to “have due regard to”.
Question, That the Committee is content with the clause, subject to the Committee being satisfied with the wording of the Department’s proposed amendment, put and agreed to.
Clause 18, subject to the Committee being content with the wording of the Department’s proposed amendment, agreed to.
Clause 19 (Public involvement and consultation)
The Temporary Chairperson:
During previous discussions, members were content with the clause as presently drafted apart from a question in relation to clause 19(1)(a) about the provision of information. The Department has agreed to reject it, so we will defer it.
Clause 19 referred for further consideration.
Clause 20 (Public involvement: consultation schemes)
The Temporary Chairperson:
During previous discussions, members were content with the clause as presently drafted. Have officials given any consideration to the change in wording from “have regard to” to “have due regard to”?
Mr McMaster:
When we were going through the Bill, the change in wording was not mentioned. However, for consistency, we feel that the words “to have regard” in clause 20(3)(a) should be changed to read “to have due regard”.
Question, That the Committee is content with the clause, subject to the Committee being satisfied with the wording of the Department’s proposed amendment, put and agreed to.
Clause 20, subject to the Committee being content with the wording of the Department’s proposed amendment, agreed to.
Clause 21(Duty on HSC trusts in relation to improvement of health and social well-being)
The Temporary Chairperson:
The Department has agreed to accept our recommendations.
Mr Gallagher:
What were our recommendations?
The Temporary Chairperson:
During previous discussions, members had suggested the inclusion of a reference to reducing health inequalities, and officials agreed to consider that further. A suggestion has been made to include “and reducing health inequalities” after the words “health and social well-being”.
Mr Gallagher:
It is the trusts’ duty to consult with the people for whom they provide the services. Is that included?
Mr McMaster:
In common with the organisations that we are creating under the legislation, the trusts will have an obligation to complete a consultation scheme that will show how they will consult with the people for whom they provide the services. They are required to submit a scheme to the Department in nine months; we will scrutinise and approve that scheme if it is suitable.
Question, That the Committee is content with the clause, subject to the Committee being satisfied with the wording of the Department’s proposed amendment, put and agreed to.
Clause 21, subject to the Committee being content with the wording of the Department’s proposed amendment, agreed to.
Clause 22 (Public-private partnerships)
The Temporary Chairperson:
During previous discussions, members expressed concern about the principle of public-private partnerships.
Mrs Hanna:
In clause 22, is it possible to include appropriate wording to reflect some members’ concerns generally about PFIs, and not just in cases into which public-private partnership is to be entered? I accept the Department’s formal response to the Committee’s suggestion, but is it possible to include appropriate wording to reflect some members’ general concerns about PFIs?
The Temporary Chairperson:
If members still have concerns about that issue, we will refer the clause.
Mr McMaster:
Do you want that to be included in the legislation?
Mrs Hanna:
Is that possible? I understand that it might not be, because it is a principle.
The Temporary Chairperson:
Will the Department examine whether that is possible?
Mrs Hanna:
We can refer that clause until the next time.
Clause 22 referred for further consideration.
Clause 23 (Schemes for the transfer of assets and liabilities)
Mr McMaster:
When we re-examined schedule 5, we discovered that an explanation was missing. Schedule 5 provides the details of schemes whereby staff are transferred. It also lists the three types of bodies that should not be present at any hearing of resolution of disputes.
When schedule 5 was initially drafted, we thought that we did not need to include the transferor body — the body from which employees are transferred — because we considered that those bodies would be done away with on day one. However, employees may be transferred after that date. Therefore, we will include the appropriate wording in schedule 5 to ensure that a body from which employees are transferred is not involved in any dispute resolution. That will bring the Bill into line with the Libraries Act ( Northern Ireland) 2008.
Question, That the Committee is content with the clause, put and agreed to.
Clause 23 agreed to.
Clauses 24 to 28 agreed to.
Clause 29 (Orders, regulations, guidance and directions)
The Temporary Chairperson:
The Committee has received further information from the Examiner of Statutory Rules since the Department’s paper. Therefore, I suggest that we refer clause 29.
Clause 29 referred for further consideration.
Clauses 30 and 31 agreed to.
Clause 32 (Minor and consequential amendments)
The Temporary Chairperson:
Officials have explained that some technical changes must be made to schedule 6.
Question, That the Committee is content with the clause, put and agreed to.
Clause 32 agreed to.
Clauses 33 to 35 agreed to.
Schedule 3 agreed to.
Schedule 4 agreed to.
Schedule 5 referred for further consideration.
Schedule 6 referred for further consideration.
Schedule 7 agreed to.
The Temporary Chairperson:
I would love to say that that concludes the Bill’s formal clause-by-clause scrutiny; however, it does not, because several clauses have been referred for further consideration. Nevertheless, thank you for your patience, and we shall return to those matters at the next meeting.
Mr Mitchell:
Would it be helpful if the Department drew up a paper for the next meeting, outlining any referred matters and changes that were suggested during this discussion?
The Temporary Chairperson:
Yes, that would be helpful.
Mrs McGill:
Will members receive that paper in advance of the next Committee meeting?
Mr Mitchell:
You will. The turnaround time did not permit earlier submission on this occasion.
The Temporary Chairperson:
We will be in recess for a week.
Mr Mitchell:
Do you require any further information on, for example, agency matters? Should we bring any additional material?