Chronic Pain Management (PE374)<br />Myalgic Encephalomyelitis (PE398)
Organ Retention (PE406)<br />Autistic Spectrum Disorder (PE452)
Heavy Metal Poisoning (PE474)<br />Aphasia (PE475)
Psychiatric Services (PE538)<br />Multiple Sclerosis (Respite Homes) (PE572)
Autism (Treatment) (PE577)
Item 3 is consideration of public petitions. There are some issues arising from the petitions, so this item will perhaps take a little bit longer. Members have in front of them a cover note that identifies several petitions on which additional information is awaited, as well as current and new petitions that require to be considered today and which are listed on the agenda. All members should have annex A to paper HC/S2/04/21/1, which gives an update on nine petitions.
I am very concerned. I have known Mr Mackie very well for many years. He has submitted loads of petitions to Parliament over the past five years and, to be quite frank, I think that you would be rather generous to allow him 28 days. I would prefer you to stiffen up that time limit to 14 to 21 days, because I know that people have given him evidence and bits and pieces to work with. It is not for us to carry on that work; it is for him to deal with.
Are members in favour of that counter proposal, that we reduce the time limit from 28 days to 21 days?
Shall we say that he has to respond by the end of the October recess?
That is 21 days.
I need a clear suggestion. Does his having to respond by end of the October recess amount to 21 days? Are there any advances on a time limit of 21 days? Do members agree to the 21-day suggestion?
If Mr Mackie does not respond, we will be able to continue our consideration of the other autism petitions. The clerk has just pointed out to me that petition PE474 from Mr Mackie is in the same position—we await a response from him. Again, we should invite him to respond within 21 days; if he does not, we will assume that he is no longer interested. Are members happy with that and with the recommendations that are contained in annex A for dealing with all the other petitions?
Epilepsy Service Provision (PE247)
That allows us to move on to consideration of petitions PE247, PE609 and PE756, two of which are current petitions and one of which is new. PE247 is from Epilepsy Scotland and calls for the provision of services to benefit people with epilepsy. Paper HC/S2/04/21/2 includes a note of possible action in paragraph 15, which members have no doubt read with interest. We are invited to note the replies from the Executive and the data on epilepsy nurses from the data collection on clinical nurse specialists.
Is there a summary of the points that have not already been addressed in correspondence? Such a summary might be among the papers, but I cannot see it. Perhaps we could get a steer from the clerks on whether there are outstanding issues.
I am advised that we would, before our next meeting, have to involve the Scottish Parliament information centre in pulling together any unresolved issues. Does the committee want to do that before we dispense with the petition?
I do not disagree with that suggestion, but I thought that when we got to this stage, we normally asked the petitioners for their views on the Executive's response.
We think that that has been done.
I just wanted to check on that.
I would like to turn to the letter in annex A of paper HC/S2/04/21/2.
Can you be a bit more specific?
It is on page 3 of the bundle of papers.
Are you talking about the letter from the Scottish Executive Health Department?
Yes. The second paragraph contains the comment that NHS Quality Improvement Scotland does not appear to have any responsibility for implementation of Scottish intercollegiate guidelines network guidelines. Can we get some background on why that statement has been made? According to the minister, NHS QIS's role is—
Can you identify where you are getting that information from? Are you talking about the letter from the Health Department?
The letter starts:
Which paragraph are you talking about and which page is it on?
It is in the second paragraph.
On the first page?
Yes. The gist of that paragraph is that the Executive is not monitoring the work of clinical governance committees. It goes on to say:
If SPICe is going to examine some of the unresolved issues, it could also provide us with a note on the precise role of NHS QIS and, in light of that paragraph, what—if anything—we should expect to get from NHS QIS on a regular basis.
The Health Department appears to be saying that NHS QIS does not have a locus in the matter, but I thought that it had a locus in all matters that relate to standards in the health service, because the minister said so early on when NHS QIS was first formed and has said so since.
That might be an additional matter that SPICe can advise us about.
I want simply to emphasise the importance of early diagnosis, especially in epilepsy, which is well known about. I thought the same as David Davidson when I read the paper. There is no indication of how we can find out whether there is early diagnosis in primary care or by specialist nurses. There is no feedback on whether we are improving a service. The answer from the petitioners is obviously that we are not improving a service, but the committee ought to be trying to do so.
There are issues in the last paragraph on the first page of the letter, which states:
It is obvious from the discussion that there are unresolved issues and that it would be premature to close consideration of PE247. When we ask SPICe to do what we want it to do, we might direct its attention to the specific issues in the letter relating to NHS QIS and to the managed clinical networks, and to an audit of their effectiveness as they have spread; that is, who is doing what and where and where the models of best practice are, as Duncan McNeil mentioned. Perhaps SPICe can produce a paper to kick us off. We can then reconsider petition PE247. Are members happy with that proposal in the meantime?
Eating Disorders (Treatment) (PE609)
The next petition is PE609, from Mrs Grainne Smith, on behalf of North East Eating Disorders Support Group and the Scottish Eating Disorder Interest Group. A paper has been prepared subsequent to a discussion that the committee apparently had on 14 September. The conclusions of the paper are contained in paragraph 19. It is clear that we will attempt to have an inquiry into the matter.
That would be a sensible way of proceeding. It would save the committee and the petitioners a great deal of time.
I thought so.
I declare a family interest in the matter.
We should also ask the Royal College of General Practitioners to give evidence, because—let us face it—many people with such disorders turn up in the first instance at GPs and get no help at all. Perhaps the college could give us an idea about training in diagnosis of such disorders at general practice level.
Let us start by agreeing the remit of the inquiry. Do we want the remit to cover the four bullet points in paragraph 13 in the paper?
Right. Do we want to issue a call for written evidence?
Paragraphs 15 and 16, which are about the timescale for the inquiry, mention oral evidence-taking sessions. Given that some of the information that we seek is factual and can be gathered in advance, and given that it will not be particularly easy to fit in the inquiry—although we have agreed to do it for the right reasons—we should have two oral evidence-taking sessions and we should issue a call for written evidence from those from whom we may not be able to take oral evidence.
Jean Turner made a specific recommendation. I presume that she wants the Royal College of General Practitioners to give oral evidence.
Yes—but it might be good to get written evidence in advance because time is scarce and the written evidence would allow us to ask the right questions.
Can members think of other organisations that we should approach for written evidence?
In the past, we have made a policy decision to send out for written evidence and then to decide who to call as oral witnesses on the basis of the written evidence, which informs us whether we want to pursue an issue.
That is a reasonable request.
The issue is whether the request for written evidence should be drawn to the attention of particular organisations, rather than just publicised. We need to ensure that the request is flagged up to organisations that we want to include, but which otherwise might not realise that the inquiry is taking place. The interest groups will know about it, but some other organisations might not necessarily be aware of it.
As an addition to the list of recommended witnesses in paragraph 17, we ought to write to the health boards to allow them to offer input and explain what they do. Some health boards may work with other boards, but we would miss that in the trawl. Perhaps we should also write to the Institute of Psychiatry, which has done work in the field. Given that GPs refer to regional psychiatric services as a first stop, it would be helpful to get some professional input from the institute.
We have on the list representatives from the three Scottish regional planning groups. I do not know whether members read the letter from Dr Harry Millar, but on page 3, in the paragraph that is a response to a letter from Trevor Lodge in the Health Department, he comments on the efficacy of the north of Scotland planning group. It might be useful for us to note that, not just for this inquiry, but perhaps for our work force planning inquiry—I think that the regional planning groups are also on the list for that inquiry. Dr Millar makes some fairly trenchant criticisms of the planning groups.
I thought that he was remarkably polite.
It is worth flagging that up.
Parliament gets a lot of criticism for having short intervals between calling for written evidence and proceeding with oral evidence, so it would be better to start taking oral evidence in 2005.
Are we agreed on January 2005?
At the moment, we are planning two or three oral evidence-taking sessions. There is quite a long list of possible witnesses already, with an extra one added on, so it is beginning to look as if we will have three evidence-taking sessions rather than two, to be realistic. We will put that aspect of the decision off until the written submissions have given us an indication of interest and we will delay the start of the oral evidence taking until January, which will give those who want to make submissions plenty of time and allow time for the information to go round.
Maternity Services (PE756)
Petition PE756, from Dr Federica Warnock, is on the provision of maternity services in remote areas. There is a paper on the petition that suggests, at paragraphs 5 and 6, possible action. It seems to me that it would be most sensible to include the petition in the evidence for our inquiry into workforce planning.
I am happy to do that, but should we also keep an eye on ensuring that we deal with the issues that are raised in numerous other petitions, including PE756, in the workforce planning inquiry. It would be easy to overlook such issues in the course of the inquiry; we need to keep an eye on specific issues to ensure that they are covered.
It is important that we get a summary of the issues that are common to the different petitions. Where the petitions agree, they all argue pretty much the same thing. We should ensure that we have a check list so that when we deal with the workforce planning inquiry, the issues are raised.
It is important to keep an eye on things. There is an opportunity to consider such issues in the workforce planning inquiry, but there is also an opportunity to consider them under the work that David Kerr's advisory group on service change is doing. Whatever comes out of that work might give us an opportunity to discuss the various issues. I presume that the advisory group's report will come to the committee.
That report will come to us.
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