Health and Community Care Committee, 08 Sep 1999

Meeting date: Wednesday, September 8, 1999

Official Report 245KB pdf

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Health Minister (Invitation)

Item 2 on the agenda is an invitation to the Minister for Health and Community Care to come to speak to us. We had a good meeting yesterday. Susan answered all our questions very well and it was good to be able to have her at a committee meeting so early, although the situation was slightly unusual in comparison with what we are discussing now. We are inviting her to talk on a wide spectrum of health issues and to tell us how she views her role in carrying out the Executive's work plan and in working with the committee.

I want to ask two questions. We have invited the minister, but does the committee want Iain Gray, the junior minister, to come with her? I see from the number of members nodding that the answer is yes, so we will extend an invitation to him.

Part of his remit is community care.

Yes.

We have full diaries, so we will probably not be able to do that soon. Susan Deacon will be here on 6 October to discuss the Arbuthnott report, so she will have been to see us twice before she comes formally to discuss wider issues. That is not a bad thing for the committee because it will give us a chance to get an idea of what we really want to ask her.

The minister was here for the debate on amnesic shellfish poisoning. Are you saying that she will also be here to discuss the Arbuthnott report?

Yes. She invited herself to both meetings because of the circumstances.

It might be useful to have the minister here to discuss amnesic shellfish poisoning and other such specific issues, but I am not sure that there is much value in inviting the minister in for general discussions. Having heard this morning's discussion and thinking about our individual interests, we could end up going round in circles. I might want to address an issue that is of interest to me, and someone else might want to go down a different route.

It would be more beneficial—in terms of holding the Executive to account—for us to give ministers specific subjects on which we want to question them. That would allow us to go into those subjects in much greater depth and would also allow the ministers to focus better.

Susan Deacon will get advance notice of the issues that we want to discuss. The discussion will be free-ranging. We want to raise issues such as cervical cancer screening—the minister has already been told that we will probably want to ask her about it.

That is important. I raised with you the question of cervical cancer screening because I wanted to know that there would be an opportunity for us to discuss that. I am content to hear you say that there will be a report, which we can examine and question as appropriate.

If, however, we simply say to the minister that we would like to discuss community care, addiction, drugs or whatever, things will get out of hand. We must say to the minister that we want her to come to the committee to represent the Executive on specific issues.

As Mary said earlier, community care is such a wide-ranging topic that the discussion could go anywhere. We need to decide what we are not happy with. I would rather that the minister was brought in to say what the Executive intends to do about the potential crisis in the NHS during the winter. The committee would be more productive if we could tease out a range of things.

The danger is that the broader the issue, the less accountable the Executive becomes.

My take on that is that there are two things that we must consider. The first is that there are several years ahead of us, and no doubt there will be any number of occasions on which we will call the minister in to talk to us about particular issues.

It would be good for the committee to kick off with a general discussion with Susan Deacon about how she sees the programme being put into practice. We would be able to raise some of the issues that we have talked about among ourselves. We have to give her prior notice, so that she can find spaces in her diary.

An element of courtesy is involved in such a discussion with the minister, but it does not mean that we will not be able to ask her to talk to us about issues that we might be concerned about in future. This is the starting point for a relationship between the committee and the Minister for Health and Community Care and the Deputy Minister for Community Care. I am not setting up the meeting as some great panacea, but I feel that an initial meeting with the minister will be a useful exercise for both sides. In that respect, it will be a one-off. In the future, we will call her to talk to us about particular issues.

Yesterday was useful, in that we met the minister and got to know her a bit better. However, frankly, it was not really necessary to have a minister of her high rank there for a non-controversial issue. We were not going to vote against the shellfish ban.

The minister had to be there.

The highest-ranking minister needed to be there?

It was the minister's motion, and our understanding was that she had to be there as a matter of procedure. It was her request that it be done that way, and we had to follow that due process. We did not ask her to meet us on the shellfish issue; it was quite the other way round.

I thought that a more junior minister could have been present in such circumstances. However, it was good to meet the most senior minister as the kick-off. In future, we do not want the highest-ranking minister to be called in on non-contentious issues. We want them to be present when we are discussing a contentious issue and when the Executive has to explain itself. I repeat my fear that we could have ministers coming before the Parliament to say that something is a done deal—that a decision has been taken. We do not want that—we want discussion beforehand.

On a point of order. Is the procedure that the senior minister should attend? I was aware that a minister had to attend, but should it be the senior minister?

It was the minister's choice to attend—she came at her own invitation to speak to the statutory instruments. It was not a decision for the committee to take—the minister decided that she would come to the meeting to speak to those instruments, and that is how it was left.

I, for one, will not turn down the minister when she feels that she wants to speak to us. A key part of our job is to hold the Executive to account, to scrutinise the minister and to ensure that she is ever mindful of the fact that we exist. However, it is also part of our job to work with her to deliver the best possible health care. A good relationship between the committee and the minister, established at an early stage, is to be encouraged.

While it is important to have a positive and constructive relationship with the minister, from what has been said this morning I fear that we are trying to be a bit too prescriptive. I do not want things to be sanitised—I would like to think that we could be evolutionary in our approach, and try out ideas. Convener, you suggested in our first meeting that we should suck it and see, and sometimes I think we just have to do that. We cannot sit down and say that this is precisely what we should or should not have.

I agree with Hugh that it is important to make good use of the minister's time. With a degree of good will and flexibility, the convener can use her discretion. It would be wrong to be too bureaucratic and rigorous. There should be flexibility, to take into account some of the issues that Dorothy raised earlier.

Following the documents that have been published in the past two and a half years, we could ask the minister to find out about the health service's performance in terms of implementation. For example, where are we in terms of "Towards a Healthier Scotland"? Is good practice emerging? Is someone running ahead of the rest? We should be taking stock. Where are we? Where are we going? Are there problem areas? How does the action that has been taken meet the objectives that the minister and the Executive set this week? We will know whether there are problems in meeting those objectives in our areas. We should have the opportunity to talk to Geoff Scaife, who has to implement the objectives.

I would like us to talk to Susan Deacon about an area that has caused the health service concern for many years, which is that it receives money only year on year. The budget is not indicated for the following years, so planning is a problem. Those in the health service should have an idea of funding for the next five years.

It is three now.

The period is three now, but is that sufficient? We need to ask the service whether that is enough time, because year on year was not helpful. Three years is a bit better.

You are talking about meeting Susan Deacon a few weeks hence.

Yes, I am talking about the beginning of November.

May I suggest that each of us has the opportunity to lodge a question through you?

I was going to ask whether we are happy for Susan Deacon to speak to us. At some point we must decide which areas we want to examine, so I ask each member to make a suggestion. The minister has intimated that she would be happy to refer to a couple of the issues that I mentioned to her over the summer. We have covered cervical cancer screening. The other issue that cropped up over the recess was the heat treatment of blood. It is of great concern to haemophiliacs, and Susan Deacon and I discussed it in the recess.

If everybody can make suggestions to me, we can give the minister prior notice of the areas that we want her to talk to us about. That will give her officials a chance to brief her. Is everybody happy with that? Ben Wallace has caught my eye—did you want to add anything?

I agree with Henry—

That's all right, Wallace.

I agree that we have to be specific in order to hold the minister to account. Apart from the first time, I would not like her to come to our meetings too many times for general reasons.

I saw it as a courtesy invite from the committee—a setting in train of what I hope will be a good working relationship, given the parameters within which we all work. Beyond that, Susan Deacon's visits to the committee will result from specific issues that arise in our work load. We do not have the time constantly to have general chats with people, and certainly nor does she. I am happy to put that on record. Are we happy with that decision?

What is not clear to me is whether Susan Deacon would consider handling a mixed bag of subjects on some occasions. If she is to come about a specific subject, we might tend to drag it out because a minister is here.

We have to take matters as they arise. On some occasions we might feel that there is one issue that we want to discuss with the minister. However, after a recess—particularly the summer recess, which is quite a long period when the committee does not meet—a few issues might have backed up. We are in a learning process.

I do not want to hammer something too much, but yesterday I asked Susan Deacon whether she would come before us to speak about the children's hospital.

You are hammering it, Dorothy. I will not allow that.

She said that she would make a decision within a few weeks.

I am watching the time. If everybody is happy that we invite Susan Deacon and Iain Gray, we will probably meet them at the beginning of November. However, Susan Deacon will be here before that, to speak on Arbuthnott.