Health and Sport Committee

Meeting date: Tuesday, September 18, 2018

Official Report 773KB pdf

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Subordinate Legislation

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Public Appointments and Public Bodies etc (Scotland) Act 2003 (Amendment of Specified Authorities) Order 2018 [Draft]

The next item on our agenda is consideration of an affirmative instrument. As is usual with such instruments, we will first take evidence from the cabinet secretary and her officials. Once we have had all our questions answered, we will move to a formal debate on the motion. The instrument that we are considering is the Public Appointments and Public Bodies etc (Scotland) Act 2003 (Amendment of Specified Authorities) Order 2018 in draft.

I welcome the Cabinet Secretary for Health and Sport, Jeane Freeman, and her officials to the committee for the first time since her appointment. I congratulate the cabinet secretary on her appointment and look forward to hearing from her. I put on record the committee’s thanks to her predecessor, Shona Robison, for her active engagement with the committee over time. With the cabinet secretary are Michelle Campbell from the health workforce, leadership and service transformation directorate, and Kirsten Simonnet-Lefevre from the directorate for legal services, both from the Scottish Government.

I invite the cabinet secretary to make a brief opening statement.

Thank you, convener, for your kind wishes. I express my pleasure at being before the committee for the first time. I am sure that we will meet again on many other occasions. I look forward to those exchanges and to our continued good work together, building on the work of my predecessor.

I thank the committee for the opportunity to speak briefly to it about the amending order, which seeks to remove both the Scottish Advisory Committee on Distinction Awards and NHS Health Scotland from the remit of the Commissioner for Ethical Standards in Public Life in Scotland. The draft affirmative order applies to those two distinct public bodies.

I am sure that members know that SACDA acts on behalf of the Scottish ministers with regard to granting and reviewing distinction awards for NHS consultants. In 2010, in accordance with the Scottish public sector pay policy, we froze the allocation of new distinction awards. As a result, SACDA’s duties have been limited to an annual review of current award holders, which has made membership of the committee less attractive to potential new members. In addition, the pool of potential peer reviewers at the top, A+ level has reduced, primarily due to retirement. Those issues, coupled with the fact that other members have completed the maximum term of office, including extensions, have meant that SACDA has reduced its current membership from 14 members to five. By removing SACDA from the commissioner’s remit, we expect that a simplified recruitment process can be put in place to establish a board of seven to 10 members.

NHS Health Scotland is a special NHS board that was set up to improve public health and reduce inequalities. It will cease to exist as an NHS board on the vesting of public health Scotland, which will be achieved by 1 December 2019. Currently, NHS Health Scotland has a small board of nine non-executive directors. It would be very difficult and not necessarily appropriate or proportionate to appoint new members to replace board members whose terms will complete before the end of 2019. By removing NHS Health Scotland from the commissioner’s remit, we will be able to retain appropriate membership and better manage the organisation’s transition over the next 12 months or so of its existence.

It is important to emphasise that both SACDA and NHS Health Scotland will still operate within the commissioner’s principles and ethics and that the step is being taken only to deal with short-term issues relating to recruiting committee members and retaining board members prior to a review of the distinction awards and the abolition of NHS Health Scotland.

I am, of course, happy to take questions.

I, too, welcome the cabinet secretary to her new post and to the committee.

I totally understand the practical reasons why the cabinet secretary is approaching the issue and will make some general points.

The cabinet secretary will be well aware that the office of the Commissioner for Ethical Standards in Public Life in Scotland is a parliamentary body. It is independent in its day-to-day activities, but is responsible to the Scottish Parliamentary Corporate Body, which I was a member of, and of which Sandra White is the current member for pay and conditions. I therefore have some experience from the other side.

In general, it is important that we look at increasing rather than reducing the range of ethical standards. I totally understand that some practical issues are involved, but I want to clarify something. One of the bodies will conclude in a year’s time, and I understand that public health Scotland will take over the new role. Do you intend public health Scotland to come under the remit of the Commissioner for Ethical Standards in Public Life in Scotland?

Yes.

That is very important, and I support that.

I appreciate that the Government has frozen the distinction awards since 2010. The cabinet secretary will know that there was some controversy about the awards in the past, when they were better known as merit awards. I, for one, thank our hard-working consultants and celebrate their work, and I understand that giving financial awards is one way of doing that. Under subsequent Governments, there has been a lot of controversy about merit awards; it was thought that they were not transparent and open. I am raising concerns because, in general, I would not support removing bodies from the remit of the Commissioner for Ethical Standards in Public Life in Scotland. Indeed, I would say the reverse; I would look to ensure that there is transparency for every public body.

I understand why the cabinet secretary is going for the approach and that Parliament will have an opportunity to have its say. However, it is very important that parliamentary commissioners are parliamentary and have a strong independent role and I would be concerned if the Government were to seek to remove any other bodies from the remit of the Commissioner for Ethical Standards in Public Life in Scotland in the future.

I completely appreciate, and agree with, the points that Mr Stewart has made. As he has said, the move is entirely practical.

Because we have frozen the allocation of new distinction awards, SACDA’s current role is to review existing awards. To do that, it needs A+ reviewers and we have experienced some difficulty in recruiting them. We have indicated that we will review the position on distinction awards in the future. We have begun discussions with the British Medical Association to review some of the controversial matters that surrounded the previous system and to see whether a future system could be devised that would give the recognition that David Stewart would welcome and which would be fair across the whole of our health workforce. As we do that work, we will, of course, keep the committee updated on its progress. Should there be a future system for the application of distinction awards, and not just a review of them, we would obviously want to look at SACDA’s role at that point and we would expect that to be part of the commissioner’s remit.

12:15  

I remind members that this part of the meeting is for questions and answers. There will be an opportunity to make points once the motion has been moved. Are there any further questions?

I have a second point, although I appreciate that this question will be difficult for the cabinet secretary to answer. If the Scottish Advisory Committee on Distinction Awards comes out of the standards commissioner’s remit, as we assume it will, and there is a future breach on a matter that would normally be dealt with by the commissioner, who would deal with it?

We would expect the body to continue to work in line with the commissioner’s standards. If there was a breach, we would take the opportunity, if we thought that it was correct, to refer the matter to the commissioner for his view.

Thank you. Keith Brown has a question.

I am sure that the question will reveal the extent of my ignorance of this area, as I have not been involved in it previously. I will ask it, nonetheless, and I am sure that I will be schooled in the area.

In considering this proposition, with regard to SACDA in particular, has the idea of not having the body been considered? Will that be one of the considerations as the matter goes forward? If SACDA exists just to review the awards and no new awards have been made, is there another way in which the matter could be undertaken—is that part of the thinking?

The early work that has begun includes initial discussions with the BMA about the prospect of an award system that could meet the intention behind the distinction award system in a way that would be fairer across the whole health workforce, more transparent and more evidence based. It is very early days. With a previous consultation on this, nothing happened as a consequence because no consensus could be achieved. Should we achieve consensus this time round and reach a satisfactory conclusion, a body would be needed to undertake work that would be comparable to that done by SACDA—that body may be SACDA, or there may be a revised role. The committee would, of course, be involved in all that and its views and approval would be sought.

That is the position for the future. At the minute, the role is simply to continue a review process of those who currently have awards. Although I am not clear—being almost equally as new as Mr Brown—whether SACDA could be disbanded, my instinct is to ask why we should cause additional fuss if we do not need to. We could let the body continue to do the job that it is there to do, but we have an opportunity with this practical step to increase the number of members it has to take forward its work.

Good afternoon, cabinet secretary. SACDA’s remit is now simply to review distinction awards. What power does that remit entail? Does it review and report to you, or does it review and recommend? What is the process for the review?

SACDA reviews and reports to me. My colleague Ms Campbell might have a much better understanding of this, but my understanding is that once you have a distinction award, you have a distinction award.

The awards have been frozen for some time now. What assessment has been made of the impact of that on attracting people into the health service? As we know, we are trying to attract people to come and work here from a global pool, and we know the current shortages that we have in many specialties. Has that been included in some of this work, especially in the work that is being done with the BMA? Is there a timetable for that review?

You asked whether there has been an impact, and the fact that we have increased the number of consultant positions and are filling those posts does not indicate any such impact to me. The BMA might have a view on the matter, and I am sure that it will bring that to the discussion. It is still early days with regard to those discussions, and we do not, at this point, have a timetable for their conclusion.

The policy note mentions that SACDA had three concerns: the committee should continue to be composed of medical and lay members; new appointments should be submitted for approval by the chair and medical director; and processes should be transparent. Can you confirm that reassurance on those points has been provided and that the Commissioner for Ethical Standards in Public Life in Scotland was also consulted?

Yes. I believe that the commissioner was consulted in September last year, and he expressed his contentment. He was also consulted with regard to NHS Health Scotland, and he was content in that respect, too.

Thank you.

As members have no further questions, we move to agenda item 4, which is the formal debate on the instrument on which we have taken evidence. I remind members that this is no longer a question-and-answer session, so they must put no more questions to the cabinet secretary. Officials may not speak at this stage.

I invite the cabinet secretary to move motion S5M-12935.

Motion moved,

That the Health and Sport Committee recommends that the Public Appointments and Public Bodies etc. (Scotland) Act 2003 (Amendment of Specified Authorities) Order 2018 [draft] be approved.—[Jeane Freeman]

Motion agreed to.

I thank the cabinet secretary and officials for attending. We will now move into private session for the conclusion of the meeting.

12:22 Meeting continued in private until 12:37.