We come to item 5. From the paper, members can see that the main points are two items under inquiry work for September 2012—medicines and community sport. There is also one item at the very end of the paper in which I ask for any suggestions for work that we might undertake in the run up to Christmas.
I absolutely agree but, for completeness, it would be good to put it on the record that we do not hope to use the session to analyse one particular drug and the approval process for that individual drug. We are talking about futureproofing the system for all new drugs that might emerge, so we want to look at the nuts and bolts of the system to see, irrespective of whether a drug is approved, whether there is a way in which the timeframe of the process would allow us to make speedier decisions and bring more certainty to the process. That would be a useful evidence session.
I apologise for asking this, but I have forgotten my iPad. Is the meeting on 18 September to be a panel or an evidence session?
We will now go on to confirm the witnesses for that meeting. The proposal is for a round-table meeting with the Scottish Medicines Consortium, the Association of the British Pharmaceutical Industry, consultants via the Royal College of Physicians, and representatives of up to three NHS boards.
Are we to specify those NHS boards today?
This is your opportunity to make suggestions and feed into the process.
In that case, I suggest NHS Grampian as one of the health boards. The IPTR system was brought in because of a petition from a patient in the Grampian health board area, and it did a lot of detailed work on the issue right at the beginning of the system. It would be useful for the committee to hear about that experience.
Does the committee agree?
I fully endorse Nanette Milne’s suggestion, and I suggest that NHS Lothian would be a suitable and appropriate health board to bring before the committee. The rationale for that is that the figures that I have seen as a result of a freedom of information request show that there are some issues worth teasing out about how the IPTR system is operated in that particular health board.
Do we know which health board refused the paroxysmal nocturnal haemoglobinuria treatment that was recommended by the national services division clinic at Monklands? That seems to me to bring up the question of equity. I think that the patient was in Inverclyde.
It was NHS Greater Glasgow and Clyde. I have had a couple of constituency cases. It is important to note that we are not necessarily looking at the procedure or the drug that a person applies for, but at the experience of the process that the person has to go through.
The problem with those suggestions is that it might be one of the smaller health boards that might face particular financial pressures from IPTR, unless it is backed by a risk sharing system. I wonder whether we should make it four and invite a smaller health board as well.
We can bring back suggestions and see how things would work. We should bear in mind the number of people at the round-table discussion and consider what can be managed. However, it has been useful to hear members’ comments to see how we can do things best.
Can we have a bit of flexibility on the consultants who will be in front of us? We should not simply ask the Royal College of Physicians to recommend people. If members have suggestions, they should be able to input them to the clerks for consideration. There are consultants who have to take difficult decisions at the coalface on whether to request medicines under the IPTR system. I would like to hear from people who take those decisions, rather than people who are at a more strategic decision-making level in boards.
It is useful to make that point. We can have discussions about that.
We can ask the RCP to nominate consultants it is aware of who have had particular problems. That is a very helpful suggestion.
It is. If I remember rightly—again, I am drawing on knowledge from one of the events that Nanette Milne sponsored in the Parliament—irrespective of the outcomes of IPTRs, some areas use far more than other areas. That information was available to us, Nanette. We may not be able to do this today, but I wonder whether we can work out two areas that we can contrast. We can consider why IPTRs are used fairly regularly in some parts of the country, but seldom in other parts. It might be quite useful to try to tease out the differences and the reasons for them.
Do members agree that we can consider the matter and that the clerks should work with those comments?
Do members agree to publicise the session and invite written submissions from interested individuals and organisations?
That leaves us with community sport, which is the other issue in the paper. Do any questions arise from the work programme paper or the meeting that we had?
I am sure that the inquiry will allow this to happen, but I want to consider how we quantify the health, social and community benefits from public money that is invested in community sport. I am not talking about anecdotal benefits, but outcomes that can be measured.
We can take some of that thinking on board.
I agree with Bob Doris and understand where he is coming from, but there are slightly different issues around health-enhancing physical activity. That is a wider area than sport for sport’s sake. We should not completely lose sight of the fact that we deal with health and sport and not just the health benefits of sport. We have a role in looking at communities, and part of the focus in relation to a community sport inquiry should be on sporting opportunities, regardless of whether they lead to improved health outcomes, because sport in and of itself is important. There is a distinction between sport and physical activity.
Are there any other comments on the themes of the inquiry?
I wonder whether, in calling for evidence, we should draw people’s attention to our pathways into sport inquiry, which could be a linked starting point.
I presume that, like the medicines stuff, we will be able to finalise the issue before the recess. We can take the discussion on board and see where it all fits and what we can do within the short period available to us. However, we can broadly agree the themes, taking the additional comments into account.
It sounds like a good idea. If we do not go for that chamber slot—although I think that we should—would there be an opportunity to debate the completed report at a later date? If we put recommendations in the report, we will want to debate them in the chamber and bring more focus to the Government’s response to them.
The debate would inform our report, and because we had encouraged people to take an interest in the issue, it might support or strengthen our recommendations. When we have debates in the chamber we are usually sent briefings and so on by various organisations that are interested in the issue being debated. Such a debate should generate information but would not preclude a debate on any report or recommendations that we may wish to make in future.
Thank you for your comments and co-operation.
I want to make a general point on the work programme rather than a specific point on medicines or sport. Is it okay to do that?
Yes, of course.
I want to put it on the public record, since we are discussing the work programme in public, that we need to return to the issue of health and safety after we have received the report from the Scottish Affairs Committee. However, perhaps the planning day would be the appropriate time to do that.
The deputy convener and I have discussed the issue in private along with the clerk. Although time could be found this week, it would not have been sensible to take people off the job at the height of the activity. However, the situation has plateaued and, thankfully, the number of reported cases is diminishing. Following the cabinet secretary’s statement last week, members are beginning to focus on what happened and on discussing preventive measures with the practitioners who have been involved in this serious incident. I would welcome a decision by the committee. We should have an evidence session as quickly as possible.
I echo those sentiments. We should not take people off the job in the middle of a crisis to write reports and give evidence. The right procedure is to wait until after the crisis. I would like to hear from people about the lessons that they have learned from the outbreak. I would just put a wee caveat on your point that we should have people in as quickly as possible. I would like people to come when they think that they can describe to us clearly how the situation unfolded, how it was dealt with and what lessons they have learned for the future.
I agree with Fiona McLeod. It would be reasonable to slot in a focused session, perhaps before the parliamentary recess. The issue is just about timing. It would be good to find out what lessons have been learned. In any crisis, lessons will be learned. We need to disseminate best practice on resilience across health boards in case something similar happens again—heaven forfend. I agree with Fiona McLeod that we should contact NHS Lothian, or whomever we agree should come in, and say that we would like them to come before recess, but then wait to see what they say. I believe that they will be keen to come. Drew Smith has done the committee a service by raising the issue.
I do not disagree with anything that has been said. However, it might be a little too soon to have such a meeting before recess. Obviously, that depends on the response, but we should make it clear that we are not asking people to come before recess if that would be inappropriate. A meeting soon after recess would perhaps be better. However, we should probably leave it to the clinicians or the people in charge of the response to decide that.
That is correct. We can offer a meeting as early as next week or 26 June, but we should consult NHS Lothian and the other agencies. There is no wish to command people to come here, but I am sure that they will welcome the opportunity to come. We should discuss with the practitioners when they can come before the committee.
I do not disagree with anything that has been said. The meeting might well take place on 26 June rather than 19 June, depending on the response from NHS Lothian. We should also consider inviting the health and safety and environmental health people and Health Protection Scotland, because those are the three other agencies that are involved.
We can leave it to the clerks to make the appropriate arrangements, given the committee’s discussion. Do members agree to let the clerks make the contacts and find a date that is suitable to us all for the meeting?
I thank Drew Smith for that suggestion.
We now move to agenda item 6, which we have agreed to take in private.
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