HC/S2/06/22/A Health Committee 22nd Meeting, 2006 (Session 2) Tuesday 24 October 2006 The Committee will meet at 2.00 pm in Committee Room 1. 1. Items in private: The Committee will discuss whether to take items 4 and 6 in private. 2. Health Board Elections (Scotland) Bill: The Committee will take evidence on the Bill from: Sir John Arbuthnott, Chair, NHS Greater Glasgow & Clyde; Professor William Stevely, Chair, NHS Ayrshire & Arran; Robert Anderson, Interim Chair, Lothian NHS Board; Richard Norris, Director, Scottish Health Council; Pat Watters, President, CoSLA; and Jane Kennedy, Team Leader - Health & Social Care, CoSLA. 3. Scottish Budget 2007-08: The Committee will take evidence from: Andy Kerr MSP, Minister for Health and Community Care; and, Dr Kevin Woods, Chief Executive, NHS Scotland 4. Scottish Budget 2007-08: The Committee will discuss the evidence heard today. 5. Health Board Elections (Scotland) Bill (in private): The Committee will discuss the evidence heard today. 6. Committee Work Programme 2006-07: The Committee will discuss its work programme. 7. Adult Support and Protection (Scotland) Bill (in private): The Committee will consider a draft Report. Simon Watkins/Karen O’Hanlon Joint Clerks to the Committee Room T3.40 Email: [email protected] HC/S2/06/22/A The following papers are attached for this meeting— Agenda Item 2: Health Board Elections (Scotland Bill) – Cover Sheet HC/S2/06/22/01 Witness Submissions HC/S2/06/22/02 Executive Summary of SPICe Briefing HC/S2/06/22/03 Agenda Item 3: Scottish Budget 2007-08 HC/S2/06/22/04 Agenda Item 7: PRIVATE PAPER: Adult Support and Protection (Scotland) Bill – HC/S2/06/22/05 Draft Report Agenda item 2 HC/S2/06/22/01 24 October 2006 Health Board Elections (Scotland) Bill 1. The Committee will today begin taking evidence at Stage 1. 2. Paper HC/S2/06/22/02 contains the written evidence received from today’s panel of witnesses. Note, no submission was made by the Scottish Health Council. 3. Additionally, paper HC/S2/06/22/03 is an executive summary of the forthcoming SPICe briefing paper on this Bill, and includes an analysis of respondents to the call for evidence who were in favour or against the Bill. Simon Watkins/Karen O’Hanlon Joint Clerks to the Committee Agenda item 2 HC/S2/06/22/02 24 October 2006 SUBMISSION FROM LOTHIAN NHS BOARD 1. Do you support the general principles of the Bill and the proposals for direct elections to NHS Area Health Boards? NHS Boards are by statute (Section 7 of the NHS Reform (Scotland) Act 2004) required to involve the public in the planning, development and operation of health services. The Statutory Guidance for Community Health Partnerships (CHPs) clearly sets out that CHPs would ‘most importantly involve the public, patients and carers in decisions concerning the delivery of health and social care for their communities’ and that Public Partnership Fora (PPF) would be key in engaging the public. The PPF are only beginning to function and find their feet with local communities and there is a danger that they would be undermined by having directly elected members who would become ‘the voice’ for patients rather than Boards actively engaging with users and communities in a variety of ways to explore options, proposals and views. Such views also run the risk of being ‘issues of moment’ rather than looking to the wider health agenda whilst of course, embracing in a proactive way, the aspects of health that have an impact on the population as a whole and the specific issues of minority groups which require to be addressed. We agree that Health Boards should be open, transparent and accountable to the communities they serve and we believe that NHS Lothian is achieving this in a number of ways - Patient Focus and Public Involvement work, Non Executive Directors who are elected representatives, Public Board Meetings and through the Public Annual Accountability Review held by the Minister for Health and Community Care. 2. Are there any omissions from the Bill that you would like to see added? Not applicable. 3. What are your views on the quality of consultation, and the implementation of key concerns about the accountability of NHS Health Boards? Quality of Consultation • Scottish Health Council’s Annual Review 2005 – 2006 of Patient Focus and Public Involvement Performance Assessment of NHS Lothian (July 2006) commended ‘the variety of opportunities presented to patients, carers and the community to become involved in planning and developing services’ and the development of the Public Partnership Forum (PPF) in Midlothian, West Lothian and North and South Edinburgh were seen as a good examples of involving the public at an early stage (East Lothian PPF is in the process of being established). The review noted that a significant amount of engagement work had been undertaken with people in each of the equality strands, including people with learning difficulties. 1 It was also recognised by the Scottish Health Council (SHC) that the Board has asked local communities how they wish to be involved e.g. Children and Young People’s Health and Healthcare Strategy, the development of Public Partnership Forums and that the work on engagement is an integral part of the early process of all new initiatives. ‘NHS Lothian has made every attempt to encourage participation at every level to meet its statutory and Patient Focus and Public Involvement responsibilities.’ As evidence please find attached the final report from Scottish Health Council and the Self Assessment submitted by NHS Lothian. • Improving Care, Investing in Change – Public Consultation Process and Responses to Public Consultation In June 2004, Lothian NHS Board confirmed its intention to undertake public consultation on a range of options for service change in acute services, older peoples services and mental health services. The whole consultation process was designed around a momentum of public, patient and staff involvement and is part of an ongoing process of informing and engaging, consultation and feedback that continues today, with the ICIC Steering Group including patient representatives. The attached Board Paper provides information on the extent and quality of the consultation process and how the public informed and shaped the strategic programmes. • NHS Lothian Strategic Context and Action Plan for Patient Focus and Public Involvement (PFPI) We have also enclosed a copy of our PFPI Action Plan which sets out the work that NHS Lothian will undertake in the coming years. You will see from this comprehensive plan that we are committed to ensuring that PFPI becomes ‘as much about how we do things as what we do’. • Development of Children and Young People’s Health and Health Services Strategy for Lothian 2006 - 2012 Between December 2005 - February 2006 children, young people and parents were involved in workshops and focus groups to gather their views about how Children and Young People’s Health Services might be improved from the user’s perspective. We sought to do this with a cross-section of children, young people, parents, staff and the voluntary sector with particular effort to reach out to vulnerable and ‘hard to reach’ groups. Over the 3 months there were 23 meetings involving over 130 young people between 5 – 18 years, over 20 parents and 16 voluntary organisations. We also drew on findings from previous involvement work with young people. This work aligns with and takes account of the parallel initiatives being undertaken by the Royal Colleges, the voluntary sector and by the Scottish Child Commissioner for Children and Young People. 2 We are now in the process of holding a series of public and stakeholder workshops across Lothian and have distributed to all households in Lothian with the new BT phonebook a 4 page leaflet which outlines how we have improved and invested in services over the last year as well as covering the Children and Young People’s strategy. In addition to this a Child and Family Advisory Board will be established as one of the five project groups for the reprovisioning of the Royal Hospital for Sick Children. This Board will be co-chaired by the RHSC Family Council and our Chief Nurse, and will have 2 young people representatives as well as representation from the voluntary sector, local authorities and health staff. Accountability of NHS Health Boards • NHS Lothian Scheme of Establishment / Public Partnership Fora The Scheme of Establishment sets out that Public Partnership will be a core function of CHPs and as such will be integral to their development and planning across all agendas. The PPF functions would not only include those that were set out in the CHP guidance: o Informing the public about a range of locations and services to promote a better understanding about how and where to access services; o Engaging local service users, carers and the public in discussion about how to improve health services; and o Support wider public involvement in planning and decision making to make public services more responsive and accountable to citizens and local communities. But also those that sit within a broader social contract for engagement in health: o Development and support for o Building community capacity; independent and collective o Supporting self help; advocacy; o Community based needs o Development of volunteering; assessment. o Policy development and scrutiny; The Guidance set out that the CHPs establish an appointed representative of the PPF as a full CHP Committee Member. Lothian has gone beyond this and on each of its CHP Sub-Committees there are 2 PPF representatives. The process for appointing these members to the CHP Sub-Committees was one that was developed and agreed by the PPF itself within the parameters set out in the Statutory Guidance.