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Official Report to Be Forwarded to Them Should Give Notice at the Document Supply Centre HEALTH COMMITTEE Tuesday 24 October 2006 Session 2 £5.00 Parliamentary copyright. Scottish Parliamentary Corporate Body 2006. Applications for reproduction should be made in writing to the Licensing Division, Her Majesty’s Stationery Office, St Clements House, 2-16 Colegate, Norwich NR3 1BQ Fax 01603 723000, which is administering the copyright on behalf of the Scottish Parliamentary Corporate Body. Produced and published in Scotland on behalf of the Scottish Parliamentary Corporate Body by Astron. CONTENTS Tuesday 24 October 2006 Col. ITEMS IN PRIVATE ................................................................................................................................ 3115 HEALTH BOARD ELECTIONS (SCOTLAND) BILL: STAGE 1 .......................................................................... 3116 BUDGET PROCESS 2007-08.................................................................................................................. 3133 HEALTH COMMITTEE 22nd Meeting 2006, Session 2 CONVENER *Roseanna Cunningham (Perth) (SNP) DEPU TY CONVENER *Janis Hughes (Glasgow Rutherglen) (Lab) COMMI TTEE MEMBERS *Helen Eadie (Dunfermline East) (Lab) *Kate Maclean (Dundee West) (Lab) *Mr Duncan McNeil (Greenoc k and Inverclyde) (Lab) *Mrs Nanette Milne (North East Scotland) (Con) *Shona Robison (Dundee East) (SNP) *Euan Robson (Roxburgh and Berw ickshire) (LD) *Dr Jean Turner (Strathkelv in and Bearsden) (Ind) COMMI TTEE SUBSTITU TES Mr Kenneth Macintosh (Eastw ood) (Lab) Mr Stew art Maxw ell (West of Scotland) (SNP) Margaret Smith (Edinburgh West) (LD) *attended THE FOLLOWING ALSO ATTENDED : Bill Butler (Glasgow Anniesland) (Lab) THE FOLLOWING GAVE EVIDENCE: Robert Anderson (NHS Lothian) Professor Sir John Arbuthnott (NHS Greater Glasgow and Clyde) Paul Gray (Scottish Executive Health Department) Jane Kennedy (Convention of Scottish Local Authorities) Mr Andy Kerr (Minister for Health and Community Care) Richard Norris (Scottish Health Council) Professor William Stevely (NHS Ayrshire and Arran) Councillor Pat Watters (Convention of Scottish Local Authorities) Dr Kevin Woods (Scottish Executive Health Department and NHS Scotland) CLERKS TO THE COMMI TTEE Karen O’Hanlon Simon Watkins ASSISTANT CLERK Dav id Simpson LOC ATION Committee Room 1 3115 24 OCTOBER 2006 3116 Scottish Parliament Health Board Elections (Scotland) Bill: Stage 1 Health Committee Tuesday 24 October 2006 14:01 The Convener: Item 2 is the first evidence [THE CONVENER opened the meeting at 14:00] session on the Health Board Elections (Scotland) Bill, for which we have allocated an hour. We will hear from six senior representatives of area health The Convener (Roseanna Cunningham): boards, the Scottish health council and the Good afternoon, everyone, and welcome to the Convention of Scottish Local Authorities. I first meeting of the Health Committee since the welcome Sir John Arbuthnott, chair of NHS recess. I have received no apologies. I welcome Greater Glasgow and Clyde; Professor William Bill Butler, who is the member in charge of the Stevely, chair of NHS Ayrshire and Arran; and Health Board Elections (Scotland) Bill and who Robert Anderson, interim chair of NHS Lothian, has been advised that our normal practice is to who I understand has been in the job for only two bring in the member in charge of the bill to ask weeks. Is that correct? questions after members of the committee have Robert Anderson (NHS Lothian): It is three had a chance to ask theirs. I know that that can be weeks. a little frustrating, but it is our practice. The Convener: Right. Items in Private I also welcome Richard Norris, director of the Scottish health council; Councillor Pat Watters, president of COSLA; and Jane Kennedy, team The Convener: Item 1 is to ask the committee leader in health and social care at COSLA. to agree to take in private items 4 and 6, which are discussions on evidence. It is our practice to take A number of documents have been circulated to such items in private. Do members agree to do members of the committee. The bill is intended to so? democratise Scotland’s area health boards through the provision of local elections. It Members indicated agreement. proposes that a simple majority of health board The Convener: Do members also agree to take members be elected directly by postal ballot. further discussions on the budget and work In the call for evidence we focused on four programme in private? issues, on which members will focus this afternoon Members indicated agreement. also. They are: support for the general principles of the bill and, specifically, direct elections to health boards; omissions from the bill; the quality of consultation and the implementation of key concerns about the accountability of health boards; the practical implications of implementing the provisions and any alternative approaches. The bill would have no other impact on the constitution or operation of health boards or the powers of the Scottish ministers. I would be grateful if all members and witnesses could bear that in mind when they ask and answer questions. The meeting will be long because there are many items on our agenda and I do not want us to drift off into discussions that are not relevant to the job in hand. My first question is for all the witnesses to answer in turn. Do you support the bill—yes or no—and why? Profe ssor Sir John Arbuthnott (NHS Greater Glasgow and Clyde): I have submitted evidence on behalf of the board, which does not support the bill. 3117 24 OCTOBER 2006 3118 My reason for not supporting the bill is based on The Convener: We will move to questions from my four years’ experience as chairman of NHS committee members. Greater Glasgow and NHS Greater Glasgow and Kate Maclean (Dundee West) (Lab): My Clyde, which was a period of rapid change. Much questions are for Pat Watters. When COSLA has changed in health boards under the headings leaders discussed the bill, they decided that they of accountability, public involvement and were not in favour of it. First, what is the democratic representation and responsibility. I justification for requiring that the delivery of understand the nature and purpose of the bill and I important services other than health, such as have some sympathy with it, but we have social work and education, be controlled by intelligence to share with the committee under directly elected individuals? those headings, which will indicate why we do not support the bill. Secondly, the COSLA submission states: Profe ssor William Stevely (NHS Ayrshire and “The matter is one that requires to be considered in the Arran): The health board that I represent is not in w ider context of public sector reform, and particularly the favour of the bill. current debate initiated by Tom Mc Cabe”. The board thought that in taking on board the Does COSLA think that, in future, in the context of a different structure for delivering public services, principles of the bill we would risk ending up with something that was no longer a national health health services could be delivered by directly service, which could lead to inefficient and elected individuals, or does it think that the idea just does not have any mileage? ineffective provision of health care. I am happy to amplify those comments. Councillor Watters: Our view is that we need to Robert Anderson: NHS Lothian’s submission consider how the whole public sector fits together. We have an opportunity to look at how we deliver hedged its bets a bit, but, if you read between the lines, you will see that we do not support the bill. public services in Scotland as a whole. We should not take out one part of the public services in We feel that fairly recent developments, such as considering proposal X, because we might end up the implementation of community health doing something entirely different when we look at partnerships and the coming into being of public the whole picture. partnership fora, have still to bed in. We believe that, through both those avenues, the public will For instance, why does primary care need to be have a role to influence the future shape of the part of the health sector when hospital care is service. entirely different from primary care? Does primary care naturally fit in with the health service? How Richard Norris (Scottish Health Council): do we enable local communities to become After internal discussion, we in the Scottish health healthier? How does that fit in? Local authorities council decided that we did not want to give a view have a role in delivering healthy communities, but on whether we support the bill. However, it is fair that role has been sectioned off so we end up in to say that we have some concerns about the bill’s competition with others. impact on regional planning, which we are keen to encourage among boards. Also, as others have Our main objection arises from our view that we said, the current system is fairly recent and is still need to look at the whole picture rather than just bedding in. part of it. If we look only at bits of the public services, we might find that they do not fit when Councillor Pat Watters (Convention of we try to put them together. We need to look at the Scottish Local Authoritie s): The policy of whole picture of how the public services are COSLA is that we do not support the bill. delivered and who delivers them. The idea of Our main reason is that we believe that having fewer, rather than more, organisations involved would be attractive to me. democratisation of the public services is vital but needs to be discussed in total. The bill would Kate Maclean: Has COSLA taken only a simply tinker with part of the public services. We temporary position on the bill until it sees what also believe that any change to how we organise happens with public services in general? At the the public services must be able to deliver moment, the health service stands out as the improvements.
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