health committee 25th meeting, 2006 (session 2) · 2011. 12. 20. · hc/s2/06/25/a health committee...

HC/S2/06/25/A

Health Committee

25th Meeting, 2006 (Session 2)

Tuesday 14 November 2006

The Committee will meet at 2.00 pm in Committee Room 4.

1. Subordinate Legislation: The Committee will take evidence on the following draft Scottish Statutory Instrument:

the Personal Injuries (NHS Charges) (Amounts) (Scotland) Regulations 2006

Members will hear from: Lewis Macdonald MSP, Deputy Minister for Health and Community Care; and Ross Scottish, Health Department, Scottish Executive.

2. Subordinate Legislation: Lewis Macdonald, Deputy Minister for Health and

Community Care will move the following motion—

S2M-5040 — that the Health Committee recommends that the Personal Injuries (NHS Charges) (Amounts) (Scotland) Regulations 2006, be approved.

3. Subordinate Legislation: The Committee will discuss the following negative

instrument:

the Feeding Stuffs (Scotland) Amendment Regulations 2006, (SSI 2006/516)

and will take evidence from—

Jillian Boddy, Animal Food Chain and Novel Foods Branch Food Standards Agency Scotland; and Lindsay Anderson Office of the Solicitor to the Scottish Executive.

4. Health Board Elections (Scotland) Bill: The Committee will take evidence on

the Bill from:

Bill Butler MSP, Bill Sponsor.

HC/S2/06/25/A

5. Car Parking in Scottish Hospitals: The Committee will consider a letter from the Scottish Executive.

6. Health Board Elections (Scotland) Bill (in private): The Committee will discuss

the evidence heard today. 7. Scottish Budget 2007-08 (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/S2/06/25/A

The following papers are attached for this meeting—

Agenda items 1 and 2: The Personal Injuries (NHS Charges) (Amounts) (Scotland) Regulations 2006 – briefing paper The Personal Injuries (NHS Charges) (Amounts) (Scotland) Regulations 2006 Agenda item 3: The Feeding Stuffs (Scotland) Amendment Regulations 2006, (SSI 2006/516) – briefing paper The Feeding Stuffs (Scotland) Amendment Regulations 2006, (SSI 2006/516) Agenda item 4 Health Board Elections (Scotland) Bill – Suggested Draft Amendments Health Board Elections (Scotland) Bill :Financial Memorandum Scrutiny Agenda item 5: Car Parking in Scottish Hospitals – briefing paper Agenda item 7: PRIVATE PAPER: Scottish Executive Draft Budget 2007-08 – Draft Report

HC/S2/06/25/01 HC/S2/06/25/02 HC/S2/06/25/03 HC/S2/06/25/04 HC/S2/06/25/05 HC/S2/06/25/06 HC/S2/06/25/07 HC/S2/06/25/08

Agenda Items 1 & 2 HC/S2/06/25/01 14 November 2006

Health Committee

Subordinate Legislation –Affirmative Instrument

The Personal Injuries (NHS Charges) (Amounts) (Scotland) Regulations 2006

1. Lewis Macdonald MSP will today move the following motion: S2M-5040 — that the Health Committee recommends that the Personal Injuries (NHS Charges) (Amounts) (Scotland) Regulations 2006, be approved. 2. Before doing so, Mr Macdonald will give a brief statement outlining the

Executive’s position on this issue; there will then be an opportunity for members to question the Deputy Minister.

Background to the Draft Instrument 3. The objective of this instrument is to establish a scheme – to be called be

called the NHS Scotland Injury Costs Recovery Scheme (ICR) - so that those deemed responsible (through the payment of personal injury compensation) for causing injury to others, are also required to make a payment contributing to the costs of any NHS hospital treatment required by the injured person and ambulance costs.

4. This will be similar to the long-established system in place to recover the

costs of treating the victims of road traffic accidents. 5. The Scottish Executive and the UK Department of Health held a

consultation on this issue in 2002. Support for the proposal came from organisations such as the TUC and the Health & Safety Executive; however there were concerns came from organisations representing businesses and insurance companies – chiefly because of the potential impact of it on Employer's Liability Compulsory Insurance (ELCI).

6. Nonetheless, the legislative framework was put in place in the UK Health

and Social Care Act 2003 (with a Sewell motion for Scottish Ministers) - however it was agreed that the ICR Scheme would not be implemented until a study of ELCI was completed.

7. This was completed just after the Act received Royal assent - with a

recommendation (which was accepted) that the ICR scheme be postponed for a year to allow other proposals on ELCI to take effect.

8. A further consultation by the Scottish Executive and the Department of Health took place in 2004 - only 5 responses were sent to the Scottish Executive – copies of these responses are at Annex A.

Abridged Subordinate Legislation Committee Report 9. The Subordinate Legislation Committee considered this instrument at its

meeting on 7 November 2006. 10. The SLC have drawn to the Committee’s attention that they sought and

received further information confirming the Scottish Executive will be making a Commencement Order to bring the relevant provisions of the 2003 Act into place on 29 January 2007.


Room T3.40 Email:

[email protected]

Medical Protection Society (MPS) response to Scottish Executive consultation paper on

recovery of NHS costs in cases of personal injury compensation

MPS

The Medical Protection Society (MPS) is the leading mutual protection organisation

representing the interests of doctors, dentists and other healthcare professionals. We pride

ourselves on being a forward thinking organisation run by doctors for doctors and strive to

create an environment where medico-legal problems occur less frequently.

Currently, there are over 210,000 members of MPS in over 40 jurisdictions around the world.

In the United Kingdom MPS has 116,000 members which includes almost 20,000 GPs,

40,000 hospital doctors and 22,500 dentists. In Scotland we represent over 7,000 practising

doctors and medical student members.

MPS is 'a not for profit' mutual organisation, solely concerned with the interests of our

members and their patients.

MPS helps doctors and dentists with legal problems that arise from clinical and professional

practice. Members have access to a 24-hour medico legal helpline and professional advice

from doctors and dentists with experience of working in the medicine and possess specialist

legal knowledge.

In addition to providing indemnity against clinical negligence, as a discretionary mutual, we

are able to assist members with disciplinary hearings and the law courts including GMC

proceedings and inquests. We place a strong emphasis on education and risk management

and provide members with educational material on good practice and minimising the risk of

medical mistakes.

Comments on the Consultation Paper

Within the consultation paper, there are a number of questions, which are designed to elicit

the views of the consultees on the proposed regulations and legislation concerning the

recovery of NHS costs. As a general comment, we are happy with the way in which the

proposed regulations and legislation have been drafted. Accordingly, we do not propose to go

through the questions one by one. We do have comments to make on two issues, however.

2

Our comments are as follows:-

1. At section 3.2 (Application for a Certificate of NHS Charges - Regulation 2), it is

stated that Application for a Certificate of NHS Charges must be made within 14

days of a compensation payment being made. We do not take issue with this

proposal. However, on a related issue, we would wish to point out that there is a

general requirement to report a claim to the CRU within 14 days of notification of

such a claim. At this point, a CRU1 form must be completed. It is our

understanding that within this form will be a request from the CRU for details of

which hospitals treated the Claimant. This information may not be available early

on in the life of a claim. If it is not, then we at MPS will endeavour to provide the

relevant information to the CRU as soon as it is made available to us.

2. At paragraph 2.17 and 2.18, there is a discussion of how apportionment of NHS

costs between two or more compensators can be determined by the CRU.

Question 4 asks the following question:

"Do consultees agree that it is right to allow compensators to ask for apportionment

before the compensation has been paid, so long as they can provide sufficient

evidence to the extent of the apportionment? If not, please explain why you

disagree".

We disagree with the idea that the CRU should resolve apportionment between co-

Defendants. We recognise that the CRU's apportionment need technically only

apply to apportionment of NHS charges. However, it would be open for co-

Defendants to argue that the resolution of apportionment by the CRU should apply

to the case as a whole, including damages and costs which may be extensive. It is

our experience that apportionment is a complex issue, which demands careful

consideration of issues of not only breach of duty, but also causation. We do not

believe that it is appropriate for the CRU to adjudicate on this complex issue. The

resolution of apportionment is best left to the compensators themselves.

Medical Protection SocietyDecember 2004

British Medical Association

14 Queen Street Edinburgh EH2 ILLTelephone: 01312473000 Fax: 0131247 3001BMA web site: www.bma.org.ukSecretary: Jeremy Strachan, MA LLM (Cantab), BarristerScottish Secretary: Bill O'Neill, BSc FRCGP

BY EMAILAnna ArmesScottish Executive Health DepartmentBasement RearSt Andrew's HouseRegent RoadEdinburghEHI 3DG

Our Ref:Your Ref:

Dear Ms Armes

Direct Line: 0131 2473026Direct Fax:Email Address:[email protected]

n.l2~ eB~SCOTlAND

21 December 2004

THE RECOVERY OF NATIONAL HEALm SERVICE COSTS IN CASES OF PERSONALINJURY COMPENSATION: A CONSULTATION ON THE DRAFT REGULATIONS

I refer to Mr Scott's letter of 24 September 2004 seeking views from BMA Scotland on the draftregulations that will be made in respect of the scheme to recover National Health Service costs incases where an injured person is treated and subsequently claims and receives personal injurycompensation.

We have not answered each and every question, but wish to comment more broadly:

• Recovering costs where practicable is nothing new and it would seem reasonable for the NHSto try and recover those costs it can which are caused by negligence and acts of omission byemployers.

• In implementing this scheme, it seems sensible to adopt and adapt the regulations in place thatcover the recovery of costs for road traffic accidents.

• We are supportive of moves to improve health and safety in the workplace. This schemecreates a clear incentive for employers to fully protect workers. If they do not, and personalinjury compensation is awarded, they will liable for the treatment costs of injuries that theycould have prevented.

• The administration costs of the scheme and any knock~on effects for subsequent litigation andlegal costs should be monitored.

We have some concerns about the operation of the scheme and some possible extensions, as follows:

• We are concerned about the scheme's potential to worsen employer/employee relations. Theregulations offer incentives for employers to minimise the amount they pay in award bylooking for fault on behalf of the employee. Some large companies will routinely challengethe injured employee about their role in the accident. Given that the employer may have topay a large cost, the employee may be put under pressure not to fully report the problem, ifthey want to keep their job.

Registered as a Company limited by GuaranteeRegistered No. 8848 England Registered office: SMA House Tavistock Square London WC IH 9JPListed as a Trade Union under the Trade Union and Labour Relations Act 1974

():>--.4;

INVESTOR IN PEOPLE

http://www.bma.org.uk

mailto:Address:[email protected]

of2 21 December 2004

• We are concerned about the implications of ascertaining blame for injuries and requiring theparty at fault to pay for the cost of treatment. One extension, for example, might see amateurfootballers' injuries blamed on named opponents and the NHS seeking to recover costs fromthe teams' insurance policy. An extreme extension would see smokers blamed for the damagetheir behaviour had caused to their health. The BMA does not believe that there would be anygreat benefit from encouraging a more litigious culture or by extending this scheme to thepoint where the NHS seeks to apportion blame and gain damages for the treatment it offers.The BMA would therefore be opposed to the extension of this principle to every area as itwould undermine the social ethos ofthe NHS.

Yours sincerely

Mrs Heather CookHead of Hospital Services Division

44 Palmerston PlaceEdinburgh EH12 5BJTelephone: 0131 2201236Fax: 0131 2254271E-mail: [email protected]

Ms Anna ArmesScottish Executive Health DepartmentBasement RearSt Andrew's HouseRegent RoadEDINBURGHEH13DG

\ ,1

~k.(l\~~

Scottish Committeeof the Council onTribunals

30 November 2004

--••

RECOVERY OF NHS COSTS IN CASES OF PERSONAL INJURY COMPENSATION

My Committee has now had the opportunity to consider the consultation paper on the aboveand I have been asked to let you have members' comments.

The Committee found these papers to be particularly complex to understand and assimilateand members expressed the view that there will be difficulty in people understanding theregulations.

They commented specifically as foJlows:

• Members are dismayed that compensators must pay NHS charges before being able to t\-. S US)lodge an appeal. Whilst this might have been introduced to eliminate frivolous claims anddelaying tactics, it could be a very real burden and the requirement does not have regardto ttle fact that compensators are not necessarily going to be insurance companies as isthe case with the current scheme.

• The consultation is written On the basis that the vast majority of cases would be Where aninsurance policy is in force and the Department of Health told me that, in its view, therewas only a 'theoretical chance' of an individual having to pay compensation for injury to athird party where there was no insuran(;e'cover. However my members are concernedthat it is more than a theoretical chance and they note that there are a number ofcircumstances where insurance is not avaHable,for example to low income families or inresidential areas prone to flooding. This is acknowledged in Annex E of the consultation .

• The ability to apply for a waiver is described as being available only in exceptional cases.My Committee notes that the potential monetary ceiling is a substantia! amount which wilJbe beyond most indiVIduals' means and members seek the Executive's reassurance thatdecisions as to whether financial hardship is being caused will be taken by officialssuitably qualified to assess such matters. Members have also been unable to find anydefinition for 'financial hardship' other than 'where raising money might put an individual'shome at risk'. If this is the only benchmark, my Committee is concerned that insufficientconsideration has been given to the circumstances of the likely individuals who, withoutinsurance, may be affected.

• Members ask whether monies are to be reimbursed if an appeal is successful andwhether there will be compensation for loss of interest on those monies.

MRS E;M MACRAESecretary

-••••

I'.

DWP Department forWork and Pensions The Adelphi

1 - 11 John Adam StreetLondon

WC2N 6HT

Date: 8 November 2004

Mrs Anna ArmesScottish Executive Health DepartmentBasement RearSt Andrew's HouseRegent RoadEdinburghEH13DG

Dear Mrs Armes

E-mail: [email protected]

Telephone no: 202 7962 8100

NHS Costs Recovery - Consultation on the Draft Regulations

The Department of Work and Pensions has an interest in the appealprocedures proposed for dealing with disputes against the NHS CostsRecovery scheme. This is because such appeals will be heard by appealtribunals in the Appeals Service which is sponsored by this Department.

The Department's has the following comments on the consultationdocument which are limited to the questions raised in section 4 of thedocument regarding the procedures for dealing with review and appeals:

Q17 We agree with the proposal to reduce the absolute time limit toappeal from 6 years to 1 year. This change was introduced by our 1998Act as 6 years was considered to be too long but an absolute time limitof 12 months for accepting late appeals strikes the right balance. Itprovides protection to those who have genuine reasons for lateness,while ensuring the decision under appeal is revisited while the facts arestill fresh. For you to adopt 1 year would be in line with all other appeals(apart from Vaccine Damage which has no time limit) dealt with by the.Appeals Service.

Para 4.11 In May 2002, regulation 32(4) of the Social Security andChild Support (Decisions and Appeals) Regulations 1999 was amendedby inserting "or" between the two sub-paragraph on "reasonableprospect of success" and "interests of justice" and thereby allows theSecretary of State to accept a late appeal where he is satisfied that theconditions for "interests of justice" provisions are fulfilled.

mailto:[email protected]

Your regulation 4 requires all late appeals to be sent to a legally qualifiedpanel member and for both conditions to be satisfied. Unless this is adeliberate policy choice (and we would need to know the reasons forthis), we would ask you to reconsider the wording of this regulation. NHSCosts Recovery appeals would be the only type which follows thatprocedure. It would be confusing for the Compensation Recovery Unitstaff, who will be administering your scheme, as for other matters theycurrently follow our amended procedures and may annoy the judicial armof the Appeals Service in having to deal with one set of appealsdifferently to all others.

I attach detailed comments on the content of the regulations in Annex Cwhich I would ask to be kept confidential.

A similar response is being sent to the Department for Health inresponse to their consultation document.

Yours sincerely

JUdy :Mayo

MRS JUDY MAYO

Anna ArmesDoH

Restricted - policy

From: Judy MayoDWP ACI(A)

Date: 8 November 2004Copy: Julie Stewart ACI(A)

Jill Swainson SolA3Ian McWilliam TASMarion McFarlane ACI(S)

Consultation Draft of the Personal Injuries (NHS Charges) (Reviews andAppeals) (Scotland) Regulations 2005

1. I attach some detailed comments on the content of the aboveregulations (Annex C of the consultation document) which I hope you will findhelpful. I am happy to talk through any of the comments. Similar commentsare being sent to the Department of Health.

2. We do have one major concern on these regulations and I havespoken to our solicitors about this. Whilst we accept the listing in yourregulation 5 of our Social Security and Child Support (Decisions and Appeals)Regulations 1999 you wish to apply, we have serious doubts about whetheryou have the power to apply our regulations 36 (composition of appealtribunals) and 37 (assignment of clerks). It may be that we have missed this,as the Act is very big, and if so, if so please point us in the right direction.

3. Section 157(7) of the Health & Social Care Act 2003 provides thepower to make regulations about time and manner of making an appeal andsection 158 provides that such appeals must be sent to an appeal tribunalconstituted under Chapter 1 of Part 1 of the Social Security Act 1998.However, we cannot see any power in your Act which allows for ScottishMinisters to prescribe the composition of an appeal tribunal to hear yourappeals or for him to provide for clerks to service appeal tribunals. This latterpoint also has a knock-on effect for other regulations which you wish to applywhich require the clerks to perform procedural functions.

4. This is obviously of concern to us (and may have arisen from copyingthe format of the Road Traffic (NHS Charges) Act 1999 which got RoyalAssent a fortnight before our regulations came into force) and is obviously alegal issue more than a policy matter. Our solicitor has asked for theDepartment of Health solicitor to contact her directly to discuss this.

JUdy ::MayoDepartment for Work & PensionsA~udication & Constitutional Issues2" Floor, The AdelphiTel: (GTN 391) 28100 Fax: (GTN 391) 28541

Restricted - policy

Consultation Draft of the Personal Injuries (NHS Charges) (Reviews andAppeals) (Scotland) Regulations 2005

Regulation 1(3) - You need to add a definition of a legally qualified panelmember (see detailed comments on reg 4 below). We also think you needyour own definition of "parties to the proceedings" as that in our regulationswill not fit yours (see detailed comments on reg 5 below).

Regulation 3(1 )(b) - You have "before an appeal can be made" but in theEngland and Wales version they have "before an appeal may be made". Wefeel these phrases should be the same.

Regulation 3(3) - We think the second reference to "Scottish Ministers" in theopening should read "Compensation Recovery Unit" as in the English andWelsh version. You surely do not want the appeal to be sent to your Ministers.

Regulation 3(3)(d)(ii) - To fit in with the terms used throughout the mainDecision and Appeals regulations, the words "determined or abandoned"should be "decided or withdrawn". Appeals are never "abandoned".

Regulation 3(5) - Again we think the second reference to "Scottish Ministers"should read "Compensation Recovery Unit" as in the English and Welshversion. You surely do not want the appeal to be sent to your Ministers.

Regulation 3(6)(c) - Currently this does not provide fully for late applicationsfor appeals against waiver decisions. Should it not read "the particularsrequired under sub-paragraphs (a) and (b)" to cover the details of theexceptional hardship that would be caused.

Regulation 3(9) - Insert "appeal or" before "application" in line 2.

Regulation 3(11) - Again we think the reference to "Scottish Ministers" shouldread "Compensation Recovery Unit" as in the English and Welsh version.

Regulation 3 - Whilst you have provided for extending the time limit formaking an appeal where further information is required (your sub-paragraphs8-10), you have not provided for what happens if the information is notprovided. Regulation 33(8) and (9) of the Social Security and Child Support(Decisions and Appeals) Regulations 1999 provide for the incomplete appealto be sent to a legally qualified panel member at the Appeals Service todetermine whether the appeal van be accepted as duly made. We think youneed a similar provision as otherwise the potential appeal cannot be disposedof. Do you also not want an equivalent of our 33(10) to allow an appeal to bewithdrawn before it is sent to the Appeals Service?

Regulation 4 - Throughout this regulation you refer to "a chairman of anappeal tribunal" taking the action. Under section 7 of the Social Security Act1998, someone is nominated as a chairman of a tribunal (or one person sittingalone) only when the tribunal is actually sitting and hearing appeals. The work

Restricted - policy

described in regulation 4 is interlocutory work to determine whether an appealis valid and is not done in the tribunal forum. It is done by a legally qualifiedpanel member who is described as such in our regulations deliberately todistinguish this work from that done by an appeal tribunal.

Regulation 4(1) - Again we think the reference to "Scottish Ministers" shouldread "Compensation Recovery Unit" as in the English and Welsh version.

Reg 4(2) - See comments in the consultation response letter on paragraph4.11 of the Consultation Document. We would prefer that you provide for theScottish Ministers to admit a late appeal where the "interests of justice" aresatisfied in line with all other appeals which go to the Appeals Service.

Reg 4(6) - Again our comments in the consultation response refer, wesupport the proposal to reduce the absolute time limit to 1 year.

Reg 4 - Whilst you have provided that a refusal to extend the time limit cannotbe reopened (your sub-paragraph 7), you have not provided for the legallyqualified panel member to record the decision or for the parties to theproceedings to be notified as in regulation 32(10) and (11) of the SocialSecurity and Child Support (Decisions and Appeals) Regulations 1999. Wethink you need similar provisions.

Regulation 5(1) - Subject to the issue raised in the covering minute, apartfrom mentioning section 12 of the Social Security Act 1998 here don't youalso need to mention sections 7 and 16 and schedules 1 and 5 which providethe procedure powers?

Please note that regulation 48 of the main regulations will be removed in itsentirety before your regulations come in.

We note that you have not specified our regulation 58 (application for leave toappeal to a Commissioner from an appeal tribunal) in this package. We haveforwarded a copy of the consultation document to the Department ofConstitutional Affairs and drawn this to their attention.

Won't listing the regulations in this way, with relevant amending Sis (seeseparate comment below) in a footnote, prevent any future amendments tothe main regulations being applicable to NHS Costs Recovery?

Reg 5(6) - We do not understand what is required of the clerk in thisregulation. Do you mean notifying the compensator of the hearing date? If so,this is covered in the main Decision & Appeals regulation 49 which you havespecified in your regulation 5(2). If you mean that the clerk will copy theappeal submission and relevant papers to the compensator, then this againwould be a different procedure from all other appeals. Current operationalprocedures allow for the decision making agency (or OGD) to send theappellant a copy of the submission at the same time that it is sent to theAppeals Service. This ensures that the appellant sees the submission at theearliest opportunity and provides a welcome customer service .. Again it would

Restricted - policy

be confusing for CRU staff who are accustomed to the procedures and wouldbe an unwelcome additional step for the administrative arm of the AppealsService, who would also require funding for this. We would not want aseparate procedure for NHS Cost recovery appeals which would benefitnobody.

Footnote (b) - You will need to add a further 2 SI references to this list for the2 packages which we are currently working on and which are expected tocome into force before Xmas recess. However, we are concerned that anyfuture amendments we may make will not apply to your regulations becausethey will not be listed.

Agenda Item 3 HC/S2/06/25/03 14 November 2006

Health Committee

Subordinate Legislation –Negative Instrument

the Feeding Stuffs (Scotland) Amendment Regulations 2006, (SSI 2006/516)

1. The Committee initially considered this instrument on 7 November 2006. 2. Members agreed to seek further information on the costs for

manufacturers arising from implementing the proposals suggested by it. 3. Correspondence between the Clerks and the Food Standards Agency is

attached at Annex A. 4. The FSA were unable to confirm in writing detailed costings because of

issues of:

• requests for commercial confidentiality; • not all respondees to the consultation providing such information; and, • such statistical data not being collected by the Government

5. Consequently, the written response does not provide sufficient detail to

deal with the concerns of the Committee. 6. Representatives from the FSA and the Office of the Solicitor to the

Scottish Executive have therefore agreed to appear before the Committee today to discuss this issue with members.


Room T3.40 Email:

[email protected]

Annex A Correspondence between the Clerks to the Committee and the Food Atandards Agency, 7 November 2006. Clerk to FSA: Further to my colleague's telephone call earlier this afternoon, I can confirm that the Health Committee discussed the above SSI and decided to defer its decision until its meeting next Tuesday - the 14th of November. The Committee is seeking clarification, from the Food Standards Agency Scotland, on the costs for manufacturers arising from the proposals. I understand that you may be unable to supply the Committee with a detailed costing; therefore an indication of whether the costs will be significant, minor or somewhere in between will be adequate. It would be helpful if we could have this information by close of business tomorrow - Wednesday the 8th. This is our deadline for issuing Committee papers for next week's meeting. Karen O'Hanlon Clerk, Health Committee FSA to Clerk: Thank you for your email. I can say that the costs are likely to be somewhere between minor and significant, obviously this will depend upon the size and nature of the operators involved. I am unable to provide specific costs involved as companies who responded to the consultation either provided information but requested that it be kept confidential or they simply do not provide the information in the first place. Government does not collect statistical data, so we have no way of gathering such information that way. Please do get in touch if I can be of further assistance. Jillian Boddy Animal Food Chain and Novel Foods Branch Food Standards Agency Scotland


Health Board Elections (Scotland) Bill: Financial Memorandum Scrutiny

1. The Finance Committee undertook Level 1 scrutiny of the Financial Memorandum that accompanies the Health Board Elections (Scotland) Bill ‘i.e. that it should take no oral evidence on the Financial Memorandum, but should instead seek written comments from relevant organisations through its agreed questionnaire, and then pass these comments to the lead Committee’1.

2. The Finance Committee sent a questionnaire to organisations that had

an interest in, or which may be affected by, the Financial Memorandum for Health Board Elections (Scotland) Bill, namely CoSLA and the 14 Area NHS Boards.

3. The following 7 responses were received:

• Sylvia Murray, Policy Manager, CoSLA • NHS Lanarkshire • James Barbour, Chief Executive, NHS Lothian • Ewan Robertson, Director of Performance Improvement/Board

Secretary, NHS Grampian • Professor Tony Wells, Chief Executive, NHS Tayside • Sandra Laurenson, Chief Executive, NHS Shetland • Malcolm Iredale, Director of Finance, NHS Highland


Room T3.40 Email:

[email protected]

1 November 2004

SUBMISSION FROM COSLA Thank you for your letter of 26 July giving COSLA the opportunity to comment on the Financial Memorandum accompanying the Health Board Elections (Scotland) Bill. As the Committee will be aware, COSLA has a standing policy position in relation to all new legislation, namely that no consequential additional financial burdens should fall on local authorities. It has been noted from the Financial Memorandum that ‘all costs incurred in implementing the Bill would be met from existing Health Board expenditure’ and on that basis COSLA is content with the Memorandum. Yours sincerely Sylvia Murray Policy Manager

SUBMISSION FROM NHS LANARKSHIRE

QUESTIONNAIRE

This questionnaire is being sent to those organisations that have an interest in, or which may be affected by, the Financial Memorandum for the Health Boards Elections (Scotland) Bill. In addition to the questions below, please add any other comments you may have which would assist the Committee's scrutiny.

Consultation 1. Did you take part in the consultation exercise for the Bill, if applicable,

and if so did you comment on the financial assumptions made? Did not take part

2. Do you believe your comments on the financial assumptions have been

accurately reflected in the Financial Memorandum? n/a/

3. Did you have sufficient time to contribute to the consultation exercise? n/a

Costs

4. If the Bill has any financial implications for your organisation, do you believe that these have been accurately reflected in the Financial Memorandum? If not, please provide details.

The Bill does have financial implications for our organisation. These may be understated due to the "hidden" costs of supporting requests for information and the time taken by NHS employees to provide this. A very high level estimate is that this may add between 25% - 50% to the forecast costs.

5. Are you content that your organisation can meet the financial costs

associated with the Bill? If not, how do you think these costs should be met?

No, the NHS is under significant financial pressure and budgeting for these costs would be a direct reduction to our patient care budget. These costs should be met corporately by the Scottish Executive.

6. Does the Financial Memorandum accurately reflect the margins of uncertainty associated with the estimates and the timescales over which such costs would be expected to arise?

No it does not reflect the uncertainty of these estimates but it does accurately reflect timescales.

Wider Issues 7. If the Bill is part of a wider policy initiative, do you believe that these

associated costs are accurately reflected in the Financial Memorandum? not able to comment

8. Do you believe that there may be future costs associated with the Bill,

for example through subordinate legislation or more developed guidance? If so, is it possible to quantify these costs? not able to comment

SUBMISSION FROM NHS LOTHIAN

As requested please find attached the completed questionnaire. Yours sincerely JAMES BARBOUR Chief Executive

Consultation

1. Did you take part in the consultation exercise for the Bill, if applicable,

and if so did you comment on the financial assumptions made? I can confirm that NHS Lothian took part in the consultation exercise and commented on the financial memorandum.


accurately reflected in the Financial Memorandum?

No. 3. Did you have sufficient time to contribute to the consultation exercise? Yes

Costs 4. If the Bill has any financial implications for your organisation, do you

believe that these have been accurately reflected in the Financial Memorandum? If not, please provide details.

Extract from Written Evidence submission:

As one of the largest Health Boards in Scotland the cost to NHS Lothian would be substantial:

Turnout % Annual Cost Total Election Cost 30 39,881 159,523 40 53,174 212,697 50 66,468 265,871 60 79,761 319,045

Based on UK General Election Figures and using the information contained with the Financial Memorandum. We believe the costs contained within the Financial Memorandum are underestimated. A more local example to consider would be the recent referendum by the City of Edinburgh Council on Transport in February 2005, which balloted circa 325,000 people by postal vote at a cost of £0.5million. This would put the cost per ballot closer to £1.53. On this basis the costs for Lothian would be:

Turnout % Annual Cost £

Total Election Cost £

30 61,018 244,070 40 81,357 325,426 50 101,696 406,783 60 122,035 488,139

In a time when NHS Boards are expected to make year on year efficiency savings this would only add to our difficulties in meeting current targets as well as put additional pressure on clinical services.

The Financial Memorandum makes reference to savings that can be made by sending groups of ballots to households. We would question whether this would be acceptable in terms of electoral procedure but with the number of single households increasing we would doubt whether the anticipated savings will be as much as 50%. Also the above costings do not take into consideration the changes to postal charges, advertising / publicity costs for the elections or the additional costs of ad hoc elections if a Non Executive Director should leave post mid-term. 5. Are you content that your organisation can meet the financial costs


No. Would suggest the Scottish Executive should meet any additional costs. 6. Does the Financial Memorandum accurately reflect the margins of

uncertainty associated with the estimates and the timescales over which such costs would be expected to arise?

Please refer to number 4.

7. Do you have any views of potential cost in relation to the implications of

death notifications, electoral fraud, and the Book of Scottish Connections?

No.


associated costs are accurately reflected in the Financial Memorandum?

No. 9. Do you believe that there may be future costs associated with the Bill,

for example through subordinate legislation or more developed guidance? If so, is it possible to quantify these costs?

Unable to quantify at this early stage.

SUBMISSION FROM NHS GRAMPIAN

I refer to your letter to Mr Carey dated 26 July 2006 regarding the above Financial Memorandum and enclose a completed questionnaire as requested. Yours sincerely Ewan Robertson Director of Performance Improvement/Board Secretary

Enc

QUESTIONNAIRE

This questionnaire is being sent to those organisations that have an interest in, or which may be affected by, the Financial Memorandum for the Health Boards Elections (Scotland) Bill. In addition to the questions below, please add any other comments you may have which would assist the Committee’s

scrutiny.

Consultation 1. Did you take in the consultation exercise for the Bill, if applicable, and if so

did you comment on the financial assumptions made? NHS Grampian did respond by letter to the original consultation exercise for the Bid in September 2004. The Consultation Document did not contain financial assumptions therefore, no comment was made on financial aspects.


accurately reflected in the Financial Memorandum? As above

3. Did you have sufficient time to contribute to the consultation exercise? Yes


believe that these have been accurately reflected in the Financial Memorandum? If not, please provide details. Yes


associated with the Bill? If not, how do you think these costs should be met? No. In order to finance we would require an additional specific allocation by SEHD to Boards.

6. Does the Financial Memorandum accurately reflect the margins of

uncertainty associated with the estimates and the timescales over which such costs would be expected to arise? Yes

7. Do you have any views of potential costs in relation to the implications of

death notifications, electoral fraud, and the Book of Scottish Connections? No


associated costs are accurately reflected in the Financial Memorandum? Not applicable

9. Do you believe that there may be future costs associated with the Bill, for example through subordinate legislation or more developed guidance? If so, is it possible to quantify these costs? No

SUBMISSION FROM NHS TAYSIDE

Thank you for your letter of 26 July 2006. NHS Tayside’s responses to your questionnaire are as follows: Consultation 1. Whilst noting the Bill with interest, NHS Tayside did not make comment

during the consultation process, as it was not felt to be appropriate at that juncture. The Board’s view is that ultimately the constitution of NHS Boards is a matter for the Scottish Parliament and Scottish Ministers.

The Board does offer the view, however, that there is a real and significant danger that structural change of the nature proposed in the Bill will divert clinicians and managers away from modernisation of service provision, which directly benefits patients.

2. Not applicable in view of 1 above. 3. Not applicable in view of 1 above.

Costs

4. From an examination of the Financial Memorandum, there appears to be considerable uncertainty with regard to costs.

The logic in quoting average costs per Board per annum is debatable on two counts.

Firstly, it is understood from consultation with local government

colleagues that, with the exception of elections for casual vacancies, expenditure on elections is accounted for in the year in which the election is held, and that GAE funding to local authorities is increased to make allowance for such costs. It is therefore anticipated that Boards would be required under accounting conventions to account for relevant expenditure in the year in which it is incurred.

Secondly, Health Boards vary dramatically in their demography, from Orkney to Greater Glasgow & Clyde, so in this context average costs are fairly meaningless.

With regard to the potential level of costs, it is suggested that postal ballots may well be more expensive to administer than the form of election currently held for local government. Another key cost driver will be the relevance or otherwise of proportional representation. It is not clear if this is a consideration.

5. If Parliament decides that NHS Boards have to meet the costs

associated with direct elections, there is clearly an opportunity cost in terms of other services foregone and the focus of Boards and their senior staff during election periods. As the potential costs are not at all clear, this would amount to an as yet unquantified cost pressure, which Boards were being required to absorb.

One alternative would be for the Scottish Executive to allocate additional funds to Boards specifically to meet costs incurred.

6. No, for the reasons set out in answer 4. 7. Given that NHS Boards have had no locus in such matters, it would be

difficult to make any assessment of financial implications.

Wider Issues 8. As the Bill is sponsored by an individual Member, it is not viewed as being

part of a wider policy initiative.

9. Future changes in costs would be determined by any policy changes. Eg a move away from postal ballot, or in the event of proportional representation being introduced.

I look forward with interest to observing the passage of the Bill. PROFESSOR TONY WELLS CHIEF EXECUTIVE

SUBMISION FROM NHS SHETLAND

I am writing in reply to your letter received on 4 August 2006 relating to the above. Please find our responses overleaf. Yours sincerely

Sandra Laurenson Chief Executive

QUESTIONNAIRE

This questionnaire is being sent to those organisations that have an interest in, or which may be affected by, the Financial Memorandum for the Health Boards Elections (Scotland) Bill. In addition to the questions below, please add any other comments you may have which would assist the Committee’s scrutiny.

Consultation 1. Did you take part in the consultation exercise for the Bill, if applicable, and

if so did you comment on the financial assumptions made? We did comment, but did not comment on the detailed financial assumptions (see our response to question 3 below). 2. Do you believe your comments on the financial assumptions have been

accurately reflected in the Financial Memorandum? N/a 3. Did you have sufficient time to contribute to the consultation exercise? We were slightly confused by the timetable. We sent in out comments on 24 August 2006. This was in line with the deadline for consultation (25 August). However, we received your questionnaire relating to the Financial Memorandum on 4 August 2006 (the letter was actually dated 4 August 2005). This letter includes the Financial Memorandum and states that it has already been considered by the Finance Committee. Therefore, by the time we were assembling our response to the consultation, the Financial Memorandum had already been drawn up. It appears that different parts of the consultation exercise had different deadlines, which means it is hard to comment on whether we had sufficient time to respond.



The costings for the election seem reasonable. However, there is no mention of any potential increased costs for elected members. Does this mean that elected members will be paid the same as the current appointed members? Is this a realistic assumption?

5. Are you content that your organisation can meet the financial costs associated with the Bill? If not, how do you think these costs should be met?

If these costs fell on our organisation they could only be met by generating savings elsewhere in the organisation, which might have a detrimental impact on patient services. If this became a SEHD policy decision there is a good argument that the costs should be specifically funded by SEHD. 6. Does the Financial Memorandum accurately reflect the margins of

uncertainty associated with the estimates and the timescales over which such costs would be expected to arise? Yes, but see above.

7. Do you have any views of potential cost in relation to the implications of death notifications, electoral fraud, and the Book of Scottish Connections?

Not sufficiently qualified to comment


associated costs are accurately reflected in the Financial Memorandum? See response to question 4.

9. Do you believe that there may be future costs associated with the Bill, for example through subordinate legislation or more developed guidance? If so, is it possible to quantify these costs?

Not sufficiently qualified to comment

SUBMISSION FROM NHS HIGHLAND

I refer to your letter dated 26 July and now enclose the completed questionnaire. Yours sincerely Malcolm Iredale Director of Finance Enc

QUESTIONNAIRE

RESPONSE SUBMITTED BY MALCOLM IREDALE, DIRECTOR OF FINANCE, NHS HIGHLAND

This questionnaire is being sent to those organisations that have an interest in, or which may be affected by, the Financial Memorandum for the Health Boards Elections (Scotland) Bill. In addition to the questions below, please add any other comments you may have which would assist the Committee’s scrutiny.

Consultation 1. Did you take part in the consultation exercise for the Bill, if applicable, and

if so did you comment on the financial assumptions made?

Yes Yes


accurately reflected in the Financial Memorandum?

Yes 3. Did you have sufficient time to contribute to the consultation exercise?

Yes



Recognise cost, but no specific details – not the ideal way to present a business case – to either assess impact at the outset, or subsequently monitor.



No. All NHS organisations are challenged to breakeven financially and this will add an additional cost, not funded onto this challenge. Limited providers of this specialist service could give rise to additional costs.

If proposals introduced then relevant and appropriate costs should be separately funded.

6. Does the Financial Memorandum accurately reflect the margins of

uncertainty associated with the estimates and the timescales over which such costs would be expected to arise?

As above, there are uncertainties of costs in short term and longer term, due to estimate difficulties and limited suppliers together with potential financial costs around re-elections, electoral disputes, etc.

7. Do you have any views of potential cost in relation to the implications of

death notifications, electoral fraud, and the Book of Scottish Connections?

There are uncertainties in this area as noted above, which could add significantly to initial costs, and could place NHS Boards in a vulnerable position.

Wider Issues

8. If the Bill is part of a wider policy initiative, do you believe that these associated costs are accurately reflected in the Financial Memorandum?

No. The issue of public participation and engagement within the NHS is already progressed and dealt with through Scottish Executive in other areas. The potential overlap, partly with representation, may distract from major public participation in which there has been significant investment over recent years.

9. Do you believe that there may be future costs associated with the Bill, for

example through subordinate legislation or more developed guidance? If so, is it possible to quantify these costs?

Yes, costs could potentially increase due to limited suppliers, expansion of scheme, ability to administer in some areas, etc. 11-09-06


Health Committee Health Board Elections (Scotland) Bill

1. Members are asked to note the attached paper at Annex A from Mike Dailly (Principal Solicitor, Govan Law Centre) which has been submitted on behalf of Bill Butler MSP.

2. The paper suggests some amendments to the Bill with regards to the

voting procedure it envisages. 3. Members may wish to further pursue the overall proposal for the

voting structure with the Bill sponsor.


Room T3.40 Email:

[email protected]

Annex A

Health Board Elections (Scotland) Bill - Health Committee Bill Butler MSP has asked that I provide a suggested way forward to resolve a technical issue identified by Dr Gilmour at last week's evidence session. Dr Gilmour had very helpfully identified an error in paragraph 30(1)(b) with respect to the Bill's voting procedure. Clearly, at this stage any suggested amendment would be academic as the Bill may not proceed past Stage 1. However, it would be useful to consider how this issue could be resolved, and in that spirit please find attached some suggested amendments. Minor technical amendments have been suggested to para 30(1)(b), 30(2)(c), 30(4), and indeed para 8, all of schedule 1 to the Bill. If any further clarification is required please let me know and I will endeavour to assist. Many thanks Mike Principal Solicitor Govan Law Centre

Suggested draft amendments to the Health Board Elections (Scotland) Bill 1. In Schedule 1, page 9, line 18, after <and–> insert –

<( ) must contain an instruction advising the voter they may cast a number of votes which is equal to the number of positions reserved for elected members, as determined by the Scottish Ministers in accordance with section 1(3), and that only one vote may be cast against a candidate’s name, >

2. In Schedule 1, page 14, line 27, leave out from <votes> to <candidate,> and insert

<more votes are given than the number permitted on the ballot paper,> 3. In Schedule 1, page 14, line 35 before <,> insert <per candidate> 4. In Schedule 1, page 15, line 8, leave out from <voting> to <candidate,> and insert

<casting more votes than the number permitted on the ballot paper,>


Health Committee

Car Parking in Scottish Hospitals

Background 1. On 6 June 2006, he Committee held a Roundtable on the issue of Scottish

hospital car parking charges. 2. The Convener wrote to the Executive raising a number of concerns on this

issue that arose from the Roundtable. 3. A copy of the correspondence between the Committee and the Minister for

Health and Community Care is attached at Annex A. Recommendation 4. Members are invited to note the Minister’s response to the

Committee.


Room T3.40 Email:

[email protected]

Annex A Correspondence between the Convener and Minister for Health and Community Care:

28 June 2006 Car Parking Charges in Scottish Hospitals The Health Committee took evidence on issues relating to car parking charges in Scottish Hospitals on 6 June. The Committee then discussed the issues arising from that evidence on 20 June. The Committee has significant concerns in relation to the Executive Guidance on Hospital Car Park Charging and in relation to the wider issue of transport links and access to hospitals. In summary: Guidance

• Coverage: there appear to be a number of gaps in the matters the guidance seeks to address and a lack of detail and specificity, in particular, as it relates to staff charging, disabled parking, staff travel for training outwith their Board area and regular patient compassionate permits.

• Application: the application of the guidance appears to lack

consistency across NHS Boards. We would welcome your views on this.

• Monitoring: the monitoring of the application of the guidance by the

Executive appears to be poor. Could you advise the Committee of the process by which the Executive monitors how all NHS Boards and private companies interpret and apply the guidance. Could you also indicate what sanctions are available to the Executive where the guidance is not being applied and if these sanctions have been applied.

• Limitations: Can you inform the Committee of any limitations that

apply in relation to the application of the guidance e.g. in terms of when hospitals were built, the nature of procurement of the hospitals, or any other factors that would allow the guidance to be disregarded by individual hospitals or NHS Boards.

Transport Links and Access In considering the evidence on this issue it is clear to the Committee that the issue of access to hospitals extends beyond that of car parking charges. The

Committee is concerned that the surrounding public transport links to hospitals are often poor in terms of coverage, frequency and timing. The difficulties currently faced by many people may well be exacerbated in the future when changes take place to acute service provision. We would be interested to hear what plans the Executive has to ensure that Boards are dealing with this as changes progress. We welcome your views on these issues and the Committee will also be writing to the Minister for Transport to explore the wider issues of access and transport links. Yours sincerely Roseanna Cunningham MSP Convener

health committee 25th meeting, 2006 (session 2) · 2011. 12. 20. · hc/s2/06/25/a health committee...

Documents