Forward Work Plan
The community care inquiry is our next piece of work. We have sought written views on community care and held an informal briefing session. I found that useful, and I hope that other members did, too. I would like to put on record our thanks to the individuals and organisations who provided us with information.
Because we have always envisaged that our inquiry into community care would take some time to complete, we will try to dovetail it, where possible, with other work. At various points, that might mean drawing up a short interim report to feed into the on-going work that the Executive has made us aware of. We suggest that the committee should meet fortnightly to consider the inquiry, with alternate weeks being used, as and when required, to consider other items of business. That will keep our focus on what we are meant to be doing when we are dealing with community care. It would be asking too much of members if we were jumping about all over the place.
If members look at the proposed agenda and the suggested forward work plan from today, they will notice that there will be a number of evidence sessions for community care throughout March. That is the earliest that we can have the sessions as it will obviously take us some time to organise witnesses' visits.
We have also agreed to have a health board allocations briefing and a finance briefing from the Scottish Executive, which has been arranged for 23 February. On that day, we will also be considering Scottish statutory instruments and hearing Richard Simpson's report on Stobhill hospital. If members agree with that, that gives us two weeks before the next meeting—as things stand, it means that we will not meet next Wednesday.
In addition, a health economics briefing has been offered to us by the University of Glasgow. That would be useful for committee members, particularly as we will scrutinise the budget proposals for health in April and May. As an individual, I am happy to accept assistance on health economics from anybody between now and 26 April, when we will begin to examine the budget proposals for health.
The one question mark over the health economics briefing on 1 March is that the Justice and Home Affairs Committee will be considering part 5 of the Adults with Incapacity (Scotland) Bill on that day. I for one will have to give evidence to the Justice and Home Affairs Committee on that matter, because amendments are lodged in my name. Richard Simpson will also probably have to do so, and other members of the committee might have to do so as well. The health economics briefing might not, therefore, be on 1 March, and we might have to put it back. It is important, however, that all members of the committee are able to attend that meeting of the Justice and Home Affairs Committee if they so wish.
On the briefing from the University of Glasgow, I am conscious that different organisations have different views on how the health service should be funded. We should home in on the Accounts Commission. Several reports have come out indicating good practice and necessary changes to practice. That should be considered when we examine the budget proposals. I do not think that we should be pinning everything on one group. We need to hear from a mixture of people.
The university wondered whether committee members would find it useful to have a briefing on health economics—it was an individual approach to us. As we will examine the budget proposals soon, I think that that would be useful. That is not to say that I disagree with Margaret Jamieson in any way.
I had a meeting with the Accounts Commission last week on its report, "Temporary measures: managing bank and agency nursing staff". It has been coming up with high-quality reports, pointing out areas in the system where we can make changes that would improve patient care and that might save the service money.
I have indicated that I personally want to hear more about the general work of the Accounts Commission. That might be added to a general briefing day.
Robert Black, who was head of the Accounts Commission at the time, spoke, I think, to this committee, or perhaps to the Finance Committee.
Yes, we did meet him.
I suggested that the Accounts Commission, when making reports in future, should indicate the point at which this committee—for health matters—should revisit reports. In other words, we must give the boards and trusts time to implement the changes and to come into line with best practice.
It would be useful to get the Accounts Commission's view on which of its reports are relevant to the current budgeting round. It might just be a matter of the Accounts Commission making a 20-minute presentation to us, so that we do not have to read all the reports again, but read just the ones that we need to read.
I should like to return to the previous agenda item for a second. The acute services review concerns me. I do not know the timetable for that—there has been some slippage. The original idea was that the boards had to report on the local interpretation of the acute services review by December—I hear that that might have slipped to March. Taking Hugh Henry's point, I should like to ask what consultation is occurring. We could be faced with enormous problems in the summer if people do not feel that they have been adequately consulted about that process before the minister is presented with the responses on the acute services review.
We should at least ask the minister or the management executive of the health service to indicate what their expectations are on the timing of the process and what consultation they expected the boards to undertake, on behalf of the management executive in their locality, in considering the acute services review.
I agree—we can note that and follow up on it.
There are three sections to this agenda item. One is the general proposed agenda for the forward work plan, which is acceptable to everybody. If members have any suggestions or comments about that, please e-mail them to me.
The second section concerns the process for the community care inquiry. We have a list of witnesses; others have been added. Malcolm Chisholm has suggested the Consultation and Advocacy Promotion Service. If members have any other suggestions, they should e-mail them to the clerk and me.
The following is included in the list:
"Scottish Council for Independent Care (perhaps a rep. from a residential care home)".
Do you mean a residential care home or a nursing home?
I did not write it, so I am not sure about the thought process behind it.
The list should include somebody from the nursing home side. I would suggest John Downie, from the Federation of Small Businesses, who takes care of that area.
I confess that, given the size of the written submissions, I am still finishing them off. Once I reach the end, I intend to go through them again, and to decide on the people from whom we should hear oral submissions. When we were considering the Arbuthnott report and had received about two dozen submissions, it was relatively easy to remember whose written submission had made a notable impact. However, when one has been reading written submissions for weeks, it is less easy to remember that.
I suggest that we take oral submissions from any of the people whose written submissions have raised issues for me—I am sure that other members will feel the same. This is by no means an exhaustive list, which is one of the main reasons why we need to spend time on it. Let us not rush—we should ensure that we do the job properly. If that means that we have to take a bit more evidence, which might take us a few more days, so be it. Let us ensure that we get it right.
I make two general points, the first of which concerns the list of witnesses and where we might end up on that. For example, the list includes Perth and Kinross Council. I hesitate to start going down that road, although there might be a particular project there—
There is.
But I could identify projects within my own council area—
Well, it is—
Just let me finish the point.
I know of a number of good and innovative projects in the Glasgow City Council area. The same could apply across the country. We need to take care that we do not end up in a bidding war, in which we feel that we have to consider every authority. I counsel caution, because I will be adding to that list, now that I see that it could include individual councils. We should think about where we will end up if we start doing that.
Let me clarify that. The list contains a catch-all category of local authorities, and the issue concerns the way in which we tender for experts to assist us. A pilot scheme has been introduced in Perth and Kinross Council, which, if successful, might be a good move for the future. In the written submissions that we have received, other local authorities have interesting things to say. That is why the category of local authorities is there.
Another action that we have agreed, in principle, is to visit certain projects on the ground. The people who work alongside us as expert advisers will have a big part to play in saying to us, "Here's what I would suggest. Here are the areas that I think you should be looking at. Here's an area where this has been tried," and so on. I frankly do not know what is going on, in terms of community care, in every local authority area in Scotland. The category is simply there as a benchmark. I am happy for any member of the committee, or of the Parliament, or anybody, to come forward with suggestions.
Perth and Kinross Council seemed to me, when I read about it, and through comments from other people, to be in a different situation. It is being funded for a three-year innovative pilot scheme. However, other people in other councils are doing such work, as I know from having read the written submissions. Rather than not mention local authorities at all, I instructed the committee clerk to include local authorities. We should open up the debate and include the other councils at the suggestion of other members or of expert advisers, when we have them on board. That will be a big part of what we do. When we make our visits, I suggest that they should be to several local authorities.
I would like to be able to finish the point that I was making, convener.
I counsel caution in that process. Notwithstanding the fact that you have listed COSLA as a potential witness, to represent all Scottish local authorities, I can think of several authorities that are providing innovative care, which have the legitimate aspiration to be heard by the committee. If we start the process in this way, we must be aware of where we will end up, in respect of the demands that are being made on the committee. I am not sure that we could cope with them, as every authority will want to demonstrate to the committee—
We have to be selective.
That may be, but we have mentioned only one authority. We may have to be selective, but if we start the process in that way, we will become involved in an argument about our selection.
The broader point that I want to make concerns the way in which we cope with what is before us. You have spoken about visiting several projects. I do not think that we should replicate what other committees do, but sometimes we could learn from the useful way in which they use their time. The Enterprise and Lifelong Learning Committee sent out only two representatives to my constituency, to interview several organisations on behalf of the committee. Those representatives then reported back to the committee. I can see groupings—
Yes. We decided that we would have roughly three groups, which would visit different parts of the country.
We must not only start to list organisations, but start grouping.
At the moment, we are in a tendering process for people to assist us. I am concerned that the committee is expected to set remits, work out lists of witnesses, work out the direction of reviews, decide where they are going, and define the groupings for visits before we have on board the people whose expertise we should partly rely on, to ensure that we cover all the ground that we ought to cover.
There are a number of organisations from which we could take oral evidence earlier on in the process. My view is that it would be more useful to the committee and to our report if we undertook the visits after some of the initial oral evidence. The visits should certainly take place after we have had experts assisting us and pointing us towards the areas in which they think it would be useful for us to see what people are doing on the ground.
Maybe I am not explaining myself well. That is the very point that I am concerned about. I do not think that it would necessarily be helpful for us to interview an exhaustive list of organisations as a committee and then go out in small groups to visit individual organisations, facilities or projects throughout the country. That is how we should undertake the process from the start.
We are being collectively unrealistic about what we can cope with. From time to time, items such as the work on Stobhill, which Richard Simpson has been asked to undertake on behalf of the committee, will crop up. We are adding unnecessarily to the burden of the committee by considering an exhaustive list. Eventually, we may select from that list to interview witnesses, but I think that, at the start of the process, we should divide up all the projects and decide which we want to visit in small groups before reporting back to the committee. If we invite people in to give evidence before we go to visit them, we will duplicate our work unnecessarily.
My vision was not that we would go out to see the same people from whom we had heard oral evidence. The organisations that are listed as sources of potential witnesses include the Royal College of Psychiatrists, the Royal College of Nursing, the Royal College of General Practitioners and the Association of Directors of Social Work. I do not think that we will go out to see them on the ground. I was hoping to see some real nurses and social workers or real people who are having their houses adapted. I hoped that we could see things at a different level from what we normally see. With the best will in the world—they are a great bunch of people and we rely on them heavily—I do not want always to hear from the Royal College of Nursing or the British Medical Association. There are two different sides to the issue.
Ben, you have been trying to get in for some time. I apologise.
I have two points. First, I agree that national strategies and initiatives must be viewed by the whole committee, but our groups could go out to look at local initiatives. There will be a difference between those two levels of inquiry. We must understand the national strategy, because that is where we have gone wrong in the past.
My second point is that I proposed the visit to Perth and Kinross and I think that I should defend that proposal. It is self-selecting. It is, I understand, the only Executive-funded pilot in Scotland that is investigating seamless—or zipped-up—community care. The Perth and Kinross area contains both urban and rural communities, so it is a more representative case study than a Glasgow-based project might be.
I have spoken to some of the civil servants from the health department. They have said that if the Perth and Kinross project works, the Executive could consider basing its policy on that model. That is an important reason for us to look at that project; it would avoid duplication and would help us to understand the Government's thinking. That is why Perth and Kinross is on the list—because it is the only Executive-funded pilot that is considering zipped-up community care and social work.
Hugh Henry has a point. The list, which is said not to be exhaustive, is already extremely long. We must go through a logical process. We need to interview the major players, and there may be quite a limited number of them. With the written information, that should enable us to identify the perceived problems.
We should then interview many of the other interested parties. That could be done in groups, because we do not have time to do them all separately. That might give us information about projects that we might want to visit and report back on. There is a logical progression. However, if we do not approach it logically, we will be completely overwhelmed.
I have already had a presentation on the Perth and Kinross project at the primary care trust, which is one of the partners. Ben Wallace was there too and he will confirm that it was an excellent presentation. When we get our adviser on board, one of the things they should be asked to do is sift the projects and tell us which ones the whole committee should consider and which ones a group should consider. That would allow us to form a logical work plan.
I recall that we had a similar conversation before Christmas. I thought we had agreed to consider three different areas: users of services, providers of services and service planners. The fact that the list is not organised into those categories causes difficulty. We agreed the three main categories and if we were to organise matters in that way it might address the issues raised by Hugh Henry.
We would not see all those people at the same time—the process must have some structure. The list was simply an indication of the people we might want to hear from, to give committee members a chance to comment and suggest additions.
Advisers are crucial to the process. We need assistance to ensure that we do not waste our time and that we ask the right questions and speak to the right people. The committee has agreed to appoint two advisers for this inquiry and a request has been submitted to the Parliamentary Bureau. Once that request has been approved, a request will be submitted to the SPCB, because there will be funding implications. If successful, the procurement department will secure the appointment of advisers. After the meeting, I will discuss names and so on with members. As we are in the middle of the tendering process, we cannot do that in the public meeting. Such problems will persist if committees are so far into an inquiry before they can get expert advisers on board.
Expert advisers can give us good advice about marshalling lists of witnesses and the projects that the committee should visit. It seems as though we have to put the cart before the horse because of the way in which the system operates. We encountered the same problem during the Arbuthnott inquiry. I have raised it as an issue because it is the wrong way to make use of expert advisers. It does not allow us to get the best out of them.
Members have a paper on committee business in the Parliament. Five half days are available for committee business during the remainder of the parliamentary year. One of them is on the day of the Ayr by-election, so we might want to disregard that one. It would be good to initiate a debate in the chamber on community care as part of our work. I have been told that the committee business should relate to reports that committees have already completed. That would mean our reports on Arbuthnott, Stracathro and Stobhill, which will be finished by then. I would like members to consider whether there is any committee business that they would like to be discussed in the Parliament.
In the interests of openness and accountability, we should use Richard's report on Stobhill. What he is saying warrants further public debate. I would like the chamber to unite behind this concern. That would set an excellent example.
I am not sure that I would like to have a debate on Stobhill in the chamber, nor do I think that we should waste our time producing a report that responds to something that the Executive has asked us to do. This committee has touched on some fundamental issues that the Executive will have to consider. I would like Richard's report to lead on to a supplementary report that deals with consultation, accountability and health board structures. The debate could put a marker down for the Executive.
I take it that that is what other members were going to say. I see a lot of nodding around the table.
I do not disagree with that but I think that we should put down a marker on Arbuthnott. I presume that the Executive will revisit the matter. We should have a debate on it at that time.
I would like to know whether the Executive will have a debate on that. We would have to bid for that committee time—five half days are available for committee debates and there are considerably more than five committees.
Like Hugh and others, I think that we should have a debate on consultation, accountability and health board structures. I value our colleagues' comments on those matters.
I am not saying that that would not be important, but if the Executive does not decide to have a debate on Arbuthnott, we should arrange for one to take place. The issue is too important to ignore.
I will seek clarification on the matter.
I have received the Executive's interim response to our report on Arbuthnott but have not yet had a chance to study it in detail. I have asked the committee clerk to contact John Forbes so that he can have a look at its response to our response before we make our response to its response to our response.
You said that as if you knew what you meant.
Are there five half days for this committee's debates in the chamber?
No. That time is for all committees.
If we were able to have another debate in the chamber, the subject of the budget would be a good one. I do not think that there will be time to cover the issues in the half-day debate on the budget.
There will be other opportunities to raise relevant issues. For instance, there is a budget debate tomorrow. The Executive and the Opposition have a substantial amount of time to decide business and initiate debates in the chamber, but there are 16 committees and only five half days for committee debate. We should use any time we have in the chamber to deal with matters that are tied in to the work of the committee.
If we want to consider accountability, we should examine not only the NHS but the social services that are related to community care.
I do not know why you say that, Dorothy, because the individuals who are delivering social care via social work departments are democratically elected. We are talking about organisations—trusts or health boards—that are not elected. We need to be careful that we are not just dragging people in because we think that they should be here.
No. I am talking about, for example, heads of departments who are not elected at all, and who, in some instances, have behaved badly toward social workers.
But they work under the direction of those who are elected.
I suggest that we hold this matter in abeyance until we have—[Interruption.] I have just been told that we have a deadline. Is it acceptable that we flag up the fact that we would like to take forward the issue of accountability and consultation? I was going to say that we should hold this matter in abeyance because we should wait until we have Richard's full report, and then we could say, "This is a report that we have done, and we are moving forward." However, if we have to tell the Parliamentary Bureau by 15 February, I will indicate to it where we are coming from and inform it of the fact that our stance has grown out of two committee reports on Stobhill and Stracathro.
Convener, would it be unwise to include the issue of structures in the supplementary report, or is that a separate matter?
I do not know how other people feel, but I do not see how the issue of accountability can be addressed without questioning structures.
I am happy with that.
Structures would have to come into the report. We would be setting down a request for Parliament to debate an issue, and we both know, Hugh, that once a motion is down, people will take the debate wherever they wish to go, so they will discuss structures before you know it.
Another point keeps coming to my attention. I do not want to muddy the waters, but in a spirit of openness can we include the complaints procedure? I am concerned by the length of time that procedure takes and by its secrecy.
That is a reasonable point to include with regard to accountability.
I am talking about the process.
The issue of complaints came up previously in a petition from Mr Ooms, if my memory serves me correctly, and we are still awaiting a response from the Executive. We have asked for a response again.