End of Session Report 1 September 2012 - 31 August 2013

The Committee for Health, Social Services and Public Safety is a Statutory Departmental Committee established in accordance with paragraphs 8 and 9 of the Belfast Agreement, section 29 of the Northern Ireland Act 1998 and under Standing Order 48.

The Committee has power to:

• Consider and advise on Departmental budgets and annual plans in the context of the overall budget allocation;
• Consider relevant secondary legislation and take the Committee stage of primary legislation;
• Call for persons and papers;
• Initiate inquires and make reports; and
• Consider and advise on any matters brought to the Committee by the Minister for Health, Social Services and Public Safety.

The Committee has 11 members including a Chairperson and Deputy Chairperson and a quorum of 5.

1 With effect from 10 September 2012 Ms Maeve McLaughlin replaced Ms Michelle Gildernew.

2 With effect from 15 October 2012 Mr Roy Beggs replaced Mr John McAllister.

Meetings

Between September 2012 and August 2013 the Committee held 34 meetings.

Three of these meetings were held outside Parliament Buildings:

• A meeting was held at the South West Acute Hospital in Enniskillen as part of the Committee’s visit to the new facility;
• A meeting was held in Conway Mill, Belfast which was co-ordinated alongside an informal meeting with the Belfast Health Initiative; and
• A meeting was held in the Magee Campus at the University of Ulster, Derry/ Londonderry as part of a co-ordinated visit by Assembly Committees to mark the City of Culture 2013.

In addition to the above the Committee has visited:

• The Clark Clinic at the Royal Victoria Hospital;
• Adult social care facilities within the Northern Health and Social Care Trust;
• The new Sexual Assault Referral Centre at the Rowan, Antrim; and
• Foyle Hospice, Derry/Londonderry.

The Chair and Deputy Chair also undertook a study visit to Cuba as part of the Committee’s Health Inequalities Review.

The Committee went into closed session during eight of its meetings when it was considering legal advice and when it was having early working discussions on the Tobacco Retailers Bill.

Primary Legislation

Tobacco Retailers Bill

The Committee carried out pre-introductory scrutiny of the Tobacco Retailers Bill between October 2012 and March 2013. During that period it brought issues relating to the sale of illicit tobacco to the attention of the Department, and as a result, during second stage of the Bill the Minister gave an undertaking to consider how those issues could be incorporated into the Bill.

The Committee stage of the Bill began on 24 April 2013 and will end on 18 October 2013. The Committee received 24 written submissions and has taken oral evidence from eight stakeholders. The Committee has asked the Department to consider a range of amendments to the Bill and negotiation on these issues will continue during September 2013.

The Mental Capacity (Health, Welfare and Finance) Bill

In February 2012 the Department of Health, Social Services and Public Safety and the Department of Justice agreed to jointly bring forward a Mental Capacity Bill which will apply to the civil and criminal population. In May 2012 the Health and Justice Ministers met with the Chairpersons and deputy Chairpersons of the respective committees to discuss options for scrutiny of the Bill.

In January 2013, after careful consideration, the Committee for Health, Social Services and Public Safety and the Committee for Justice agreed that an ad hoc joint committee should be established to undertake scrutiny of the Bill. The membership of the ad hoc joint committee will be drawn from members of both Committees, and is likely to be formed in 2014 once the results on the consultation of the draft Bill are available for consideration.

Legislative Consent Motion – UK Care Bill 2013

On 13 June 2013 the Committee published its report on the legislative consent motion proposed by the Department in relation to the UK Care Bill. There are two aspects of the Bill which required a legislative consent motion – the abolition of the existing Health Research Authority as a Special Health Authority, and arrangements for UK-wide care homes placements.

After taking evidence from the Department, the Committee came to the view that the provisions in the Bill would enhance an individual’s choice of where they
want to reside, and assist people who wish to receive a social care package closer to family and friends. It therefore agreed to support the Department in seeking the Assembly’s endorsement of the legislative consent motion. The Assembly agreed the motion on 24 June 2013.

Subordinate legislation

The Committee considered 38 pieces of subordinate legislation and approved 25 Statutory Rules and one Commencement Order .

Budget Scrutiny

The Committee held six evidence sessions on budgetary matters and covered issues including the Departmental bids made under the monitoring rounds, the options for managing budgetary pressures in 2012/13, and the allocation of monies across the Department’s various functions. In addition, the Committee took evidence from expert witnesses on approaches to budget scrutiny in the Scottish Parliament.

Policy Scrutiny

In July 2012 the Committee began a Review of Health Inequalities. The purpose of the Review was to produce recommendations which could be considered by the Department in relation to its new public health strategy, which was out for public consultation at the same time as the Review was being conducted.

The terms of reference for the Review were to identify effective interventions to address health inequalities in other countries/regions which could be applied in Northern Ireland, with a particular focus on early years interventions. The Committee held evidence sessions with a range of expert witnesses, including the World Health Organisation. The Chair and Deputy Chair also undertook a study visit to Cuba to obtain information on its approach to early years interventions.

The Committee’s report made nine recommendations and was published on 17 January 2013 and debated in the House on 18 February 2013. In July 2013, the Minister provided a written response to the Committee’s recommendations. Negotiations with the Department on the recommendations and the contents of the new public health strategy will continue in September 2013.

During 2012/13 the Committee has been monitoring and scrutinising the implementation of Transforming Your Care (TYC). It requested quarterly updates from the Minister, as well as hearing from the Health and Social Care Board, and trade union representatives. Following the concerns in relation to the proposed closure of residential homes under TYC, the Committee has decided to examine the impact of the implementation of TYC on various programmes of care. In September 2013, the Committee will begin this work by focusing on learning disability.

Performance Scrutiny

In February 2013 the Committee raised the issue of cancelled appointments with the Department, after it discovered that during 2011/2012 approximately 180,000 outpatient appointments were cancelled by hospitals. When the Committee held its first evidence session with the Health and Social Care Board and the Health and Social Care Trusts on this matter, it discovered that the figures on cancelled appointments were not robustly recorded. The Board admitted that different Trusts recorded the reasons for cancellations in different ways, that it was not possible to know how many cancellations were truly cancelled appointments as opposed to the patient being seen by another doctor, and that it was not possible to ascertain the number of cancelled appointments which negatively impacted on the patient’s health. Furthermore, data on the effect of cancelled appointments on waiting times and hospital productivity was not available.

As a result of the Committee’s work the Department asked the Trusts to establish a short life working group to consider how information on cancelled appointments could be better collected and analysed. The group has now produced an implementation plan to improve the availability of information on cancelled appointments. The Committee will take evidence on this plan and the figures for 2012/2013 in October 2013.

Between October 2012 and March 2013 the Committee undertook detailed scrutiny of the matters detailed in four reports published by the Minister on 16 October 2012 concerning the Northern Ireland Fire and Rescue Service (NIFRS). Eight evidence sessions were held with a range of witnesses including departmental officials, NIFRS personnel (current and retired), and one of the “whistleblowers” identified in one of the reports.

When the Committee began this piece of work it was aware that the Public Accounts Committee (PAC) would be undertaking scrutiny of the Northern Ireland Audit Office’s report on the NIFRS annual accounts in April 2013. It therefore used its eight evidence sessions to gather a wide range of information and submit a list of the issues to PAC for it to investigate further. Eight issues were identified and forwarded to PAC in March 2013.

Engagement - Informal meetings and stakeholder events

On 10 September 2012 the Committee held an event to mark World Suicide Prevention Day. Eighty young people linked to various suicide prevention charities were invited to Parliament Buildings to talk to political representatives about the issues that concern them.

The event called “Youth Talks” had eight “bus stops” with Ministers, Committee Chairs and MLAs at each stop. The young people were divided into groups and had the opportunity to engage with a range of politicians. A report of the event was produced, including the young people’s concerns, and forwarded to the Department for action. The Committee has followed up on the issue of suicide prevention by bringing a motion on the need for a cross-departmental approach, and has regularly written to all departments for information on actions they are taking on this matter.

The Committee holds regular informal meeting sessions to hear from a range of organisations which cannot be accommodated within the formal meeting structures. During 2012/2013, four sessions were held with 18 organisations.

Committee motions

The Committee brought forward six motions in the 2012/13 term. These dealt with the issues of:

• Endometriosis
• Suicide Prevention
• Ovarian Cancer
• Health Inequalities
• Annual GP Health Checks
• Paediatric Congenital Cardiac Services
• Muscular Dystrophy

All motions were approved by the House.

Key priorities of the next session

The key priorities for the next session will be:

•  Completion of the Tobacco Retailers Bill
• The implementation of Transforming Your Care – beginning with the impact on learning disability services
• Review into waiting times for outpatient appointments
• Committee stage of a Bill to amend the Health and Social Care Reform (NI) Act 2009

Committee for Health, Social Services and Public Safety

Expenditure for the period 12 May 2012 – 31 August 2013