 Welcome to the 8th meeting in 2016 of the Health and Sport Committee. I would ask everyone at this time, as I usually do, to switch off mobile phones as they can interrupt the proceedings of the committee and sometimes the sound sister. Although you will see that some of us are using tablet devices and this is instead of our hard copies of the paper. The first item on the agenda today is a decision on whether the committee will consider its approach to its legacy paper and private at this meeting and indeed future meetings. Is the committee agreed to meet private? Yes, thank you. Agenda item number two is subordinate legislation, in this case an affirmative instrument. As usual, we have an evidence-taking session with the minister and his officials on the instrument. Once we have heard all of our questions answered, we will then move to the formal debate. The instrument that we are looking at today is the Scottish Public Services Ombudsman Act 2002, amendment order 2016, and we welcome this morning Minister for Sport, Health and Improvement, Mental Health and his officials. Welcome Minister Jamie Hepburn, Minister for Sport, Health Improvement and Mental Health, Brian Nisbitch, Senior Policy Officer, Health and Social Care and Integration Directorate and Claire McKinlay, Solicitor, Scottish Government and Legal Directorate, all from the Scottish Government. Minister, you have a prepared statement. I say a short one, but thank you for the opportunity to come along and say a few words about this draft order. This order will amend the Scottish Public Service Ombudsman Act 2002 in connection with the establishment of integration joint boards under the Public Bories Joint Working Scotland Act 2014. This order will see the addition of integration joint boards to the schedule 2 of the Scottish Public Service Ombudsman Act 2002. It will have the effect of including integration joint boards as listed authorities for the purpose of the SPSO Act. Any complaints raised against integration joint boards can therefore be dealt with by the ombudsman going forward. In addition, complaints and procedures used by IJBs must comply with the principles set out by the ombudsman. It will help to ensure that as we approach the first of April 2016, by which time all integration joint boards will have taken on the responsibilities that will have robust complaints handling procedures in place for all those boards. The right to seek redress from an external and independent ombudsman is, we believe, an important right for the public and by proposing this amendment to the Scottish Public Service Ombudsman Act 2002 to include integration joint boards. We are seeking to make that possible in relation to the planning of the Integrated Services Committee. Members will wish to note that this order does not take forward any new policy, as it is needed simply as a result of wider legislative changes providing for integration of health and social care. Of course, I am very happy to take any questions that any members of the committee might have. I now move to questions from Malcolm Chisholm. People are very interested in the accountability arrangements for integrated joint boards. Before anyone has recourse to the ombudsman, they would have to exhaust the complaint procedure. Is the complaint procedure for all IJBs completely contained within the IJB and, presumably, the lead officer, or would the NHS board and local authorities have any role in that, or is it completely restricted, as it were, to the IJB itself? We need to be distinct from what we are talking about. We are talking about the exercise of functions on the ground, front-line services that are covered by existing complaint procedures that already cover the health board or local government. They are already covered by the SPSO, as we will all be aware. I am sure that we have all had constituents' contact. As at various times about such matters, if we are talking about the planning of functions through IJBs, then yes, they will have their own complaints procedure. We have issued guidance to that effect, and that has to be compliant with the wider SPSO complaints principles that all bodies have responsibility to have a complaint procedure that is adherent to. That particular order now adds IJBs as a distinct body corporate to the list of bodies that the SPSO can have oversight of, and people can now complain to the SPSO too. Given that most people are more likely to make a complaint about the delivery of a service rather than the planning of it, are you saying that, in terms of the delivery of services, there would not be an issue in terms of complaints to the IJB but simply to the local authority or the health board? In essence, those arrangements are already in place. That would relate more to the delivery of the planning of integrated functions. That is an interesting answer, but it will probably add to the confusion that people will have about the accountability arrangements, because I had a meeting with a particular body yesterday, and that is precisely the question that they raised, who is ultimately accountable. For the services that I understood would be delivered through the IJB, you are saying that it is the health board or the local authority that will be accountable, but I thought that we were trying to get beyond those distinctions when it came to integrated services. That is about the delivery of the actual functions, so the accountability for planning of those services. There is an issue around the planning, and I might be wearing Brian in just to make sure that I am absolutely correct in what I am saying here in a second, but about the planning of integrated services. We are very clear and hopefully people will be clear that that is a function of the integrated joint board, but Brian, I do not know if you have anything to add to what I said. No, that is the case in relation to the planning, the strategic commissioning that the IJBs are responsible for adding them to the SPSO act will allow complaints to be made around the commissioning and the planning function, but service delivery in relation to the NHS and social work services would still rest with the local authority and with the NHS complaints procedure. That is interesting, thank you. What services are provided by the third sector or voluntary sector, how do complaints against them? Again, I suspect that that will come down to who has commissioned them, who has ultimate responsibility for them, so the commissioning body would be the body that you would complain to, but it is incumbent on each body. We have issued guidance, so integrated joint boards are subject to this process, and health boards and local authorities are already responsible for this in terms of their function to come up with their own complaints procedure that is compliant with the broad principles that the SPSO operates to, and they would need to take account of any external body that they have commissioned for service delivery as part of that process. We are simple souls here, and I do not think that we have expected any controversy around this issue, but it would be helpful for me, if Brian McClare, or yourself, if it does not matter, could give me an instance about how that would add something to the existing process. When you talk about planning, what for instance would that look like if someone had a complaint about the planning, rather than the delivery of service? I am genuinely struggling to understand what that adds to the process. Well, like you, I would not view this as a controversial matter, but it is a very straightforward matter in that we have now established, as body corporate, integrated joint boards across the country through the Public Reform Act of 2014. Those are now bodies that exist in law and exercise a public function. All we are seeking to do here is ensure that if a person has a complaint about the way that they have exercised that function, they have a right of redress, they have a right to complain to them in the first instance, and if they are dissatisfied with the way that they have handled that complaint, they can then go to the Ombudsman to seek further redress. Now, you are asking me to speculate as to what that might look like. It is obviously hard for me to say, because that is theoretical, but I suppose that without being very specific about it, because you do not want to invite complaints as such. However, if a person feels that the integrated joint board has not followed the processes that they should have in planning and co-ordinating integrated functions, that might be on the basis in which they seek to complain to an integrated joint board. What that might be could be very different to different people. Ultimately, of course, it would be subject to the complaints procedure in the Ombudsman to look at, and they could then either uphold the complaint or dismiss it on the grounds that the integrated joint board has followed the proper processes that they should have. I am seeking to provide some clarity if somebody had a complaint about a function carried out by the joint board on behalf of local government, say that it was something about their care at home or something like that. They had a complaint that would they complain through the integrated joint board or would they complain to local government or the statutory providers of that service? Or would they have to complain to both before they went to the Ombudsman? I do not believe that they would have to complain to both. Again, it is obviously a hypothetical situation, but I suspect that you are referring to actual service delivery, front-line service delivery. To be clear, that would be the responsibility of, in the instance that you have suggested there, Ms Grant, local government, but equally it could be the health board. Unless it is about the planning or commissioning of the services, but again, I can bring in Brian to clarify that if need be. Brian, do you have anything to add to that? I think that it is an interesting point that you raised. The thing that is central to this is that any complaint that is made, whether it be in relation to service delivery or planning, is dealt with appropriately. If it is a matter of service delivery and the complaint is made to the local authority member of staff, in the first instance, the local authority member of staff should pick that up, but if it is in relation to a planning matter, the complaint should be made to the integration joint board. It would go through the employer. Whoever was employing that member of staff, or it might not be a member of staff, it might be the way that the service is provided, but whoever is employing the workforce of that service, then the complaint goes through. To put it simplest, Ms Grant, if you, for example, were seeking to assist a constituent with a complaint that might go to the ombudsman, if it relates to the functions that you are talking about, it would not be that dramatically different from the process that you go through just now. Who would I write to, I guess? Thank you, convener. I am just trying to tease out a bit of a clarification in an effort to be helpful. Let us say that I, or a constituent, or I, acting on the behalf of staff, wrote to a local authority or, indeed, a health board and got it wrong, it was really a matter that was related to the integrated joint board. Am I correct in assuming that either the local authority or the health board would write back to me or my constituent, dear Mr Mackenzie, that complaint cannot be properly addressed by the local authority, and we suggest that you take your complaint to the integrated joint board and vice versa. Other than perhaps the cost of a stamp or an email, there would be no real confusion, ultimately, in terms of people wishing to take their complaint to the right agency. Mr Mackenzie is being helpful. I think that you are always trying to be helpful, Mr Mackenzie, if I could say that. In essence, we have issued guidance. The various bodies involved here have to be clear about their particular role. It is always a hostage to fortune, but I rather suspect that most complaints will continue to pertain to front-line delivery, but it is important now that we have created and the processes are already there for such complaints to be taken forward. They are already covered by the Scottish Public Service Ombudsman. However, having created integrated joint boards, it is possible that people may want to exercise a complaint against them in the way in which they discharge their functions, which is about the planning and commissioning of services. We have to allow people the right to take forward a complaint first with the body directly and ultimately, if need be, to the Scottish Public Service Ombudsman. My expectation will be the expectation of the Scottish Government, generally, that any process that involves a body getting back to say that it is not as you should be contacting, that it should be the other body, that it should be expedited and undertaken as quickly as possible to ensure that any complaint can be taken up with the relevant agency and hopefully resolved satisfactorily quickly thereafter. I do not want to be complicated, but I think that we might be getting complicated. Do you think that that is a really interesting discussion? I am really quite surprised by what you said, to be honest. My understanding was that we are getting beyond the distinction between health and local government in terms of a whole range of services. If I had a constituent and a problem about the delivery of social care, I would have assumed that I would have written to the chief officer of the integrated joint board. To make the distinction between the joint boards responsible for planning, it is up to the separate bodies to deliver it. It is like diluting the whole concept of integration. I would put it to you that it would be more appropriate if the integrated joint board also dealt with complaints about the delivery of the services for which they are responsible. Otherwise, you are diluting the whole concept. I think that we are talking about two separate things. You are talking about delivery on the one hand, Mr Shiz, and we are talking about a complaints function on the other. Clearly, it is our hope and aspiration that complaints are few and far between, but nonetheless, I think that we are all aware of our own constituency post-bag that complaints do come up now and again. They have to be dealt with, but yes, you are right in going forward that delivery of functions should be increasingly integrated. That is not to say that through integration we are not getting rid of health boards and local authorities. They still are entities in their own right. They still continue to exist and they can still continue to be involved in the delivery of those services. Where the complaint is about a particular element of that service, it is right that they are the body that is responsible. The first instance for responding to that complaint about where it is a function that they should have been properly exercising, but it is very natured by bringing the two worlds closer together through the health and social care world. I think that that will lead to a better service delivery and hopefully we will see fewer complaints going forward on that basis. It is very interesting and it does throw a different light on the whole issue of accountability, because it is almost as if you can say that whatever is delivered by this body, you will still be able to market as health or local government for the purposes of complaints, which presumably relates very closely to the issue of accountability. I find the whole conversation very interesting, but I am none the wiser about accountability than I was at the beginning. I think that you would be less clear about it with the best world. I think that you would be justifiably saying to me that if we were not doing what we are doing today, accountability would be a lot less clearer because we would have created an entity that ultimately would have no proper complaints procedure and would not be subject to oversight with Scottish Public Service Omsmen. I think that what we are doing today enhances accountability. I support the order of the point that I am making as I thought that it would be accountable for the delivery of services as well as the planning of services. That is in my mind. We need to point as well to the targeted consultation and the fact that the Omsmen have made favourable comments on the order before us. Is that correct? My understanding is that, through that consultation, everyone who responded to it was in favour of the move that we are taking forward here, including the Scottish Public Service Omsmen. I understand that the delegated powers and law reform committee has no concerns about this order as well, convener. Is there any other question? I think so. We now move to agenda item number three, which is the formal debate on the affirmative SSI, which we have just taken evidence and the usual reminder that members should not put questions at this stage to the minister at the formal debates. Of course, officials cannot speak in this debate. I invite the minister to move the motion before us. It is 4M15254. It moved, convener. Thank you. Does any member wish to contribute to the debate? I do not presume that the minister wants to say anything further. I think that we have covered it in a very useful discussion, convener. Thank you. I now put the question that is motion S4M15254 be approved. Are we all agreed? As agreed then, we just briefly suspend to allow witnesses to proceed. Thank you very much. I move to our fourth item on the agenda today, which is consideration of a petition. PE1499 by Robert Watson on creating suitable respite facilities to support younger disabled adults with life-threatening shortening conditions. Members can see from paper 3 that the committee has considered this petition as part of its palliative care inquiry, but it has also considered the issue of respite care provision for those who are transitioning from children's to adult hospice and respite services. Those issues were discussed at last week's evidence session with the cabinet secretary, as you will recall. Members will recall that the cabinet secretary highlighted the work that is being done by CHAS in determining how young adults are supported and the pilot work being undertaken in relation to respite care. Given that the action is under way to address the petition and its concerns, I am minded to suggest that we close the petition. Of course, it would remain open to the petitioner to bring forward another petition if, in the fullness of time, it transpires that the work that is currently under way does not improve the services, ultimately. Can I have some views from the members? Can we ask the petitioner's opinion on what has been suggested in the work that is going on? Obviously, we are coming to the end of the session, so at some point we are going to have to close off the petition. I will be for the petitioner to come back to the new Parliament with another petition if they are concerned, but it might be a good opportunity to get the petitioner's views and feed them into the Government as work progresses, given that there will be a bit of a gap. Get the petitioner's views now about the pilot programme that is under way? Yes, and what they think might need to be added to it, because I know respect for young people, rather than children, is a real issue all over, not just for palli to care. We can do that. We have written to the petitioner outlining our position. I do not have a response to that. I think that it would be good to get their views and get their views and feed them in, if that is appropriate. I know that we have to close at some point, but it would be good to do that. If the committee feels that way, we can tell them what we are likely to do, and if they have any views on the pilot, it is taking place. We can bring it back before the committee. Dennis? My point is that the work that is under way at the moment should have time to bed in and to be resolved. If the petitioner wishes to monitor the progress of that, he can come back if he is not satisfied. If the points have not been, I suppose, if the areas of work that he feels is required are not being met, he could bring back another petition. I think that it would look different from the current one, because I am pretty sure that the work that is being undertaken by CHAS will resolve many of the petitioner's concerns. If I recall correctly, convener, last week, when I asked the cabinet secretary and her officials about the work that was on-going and the work that they are doing with Luchy and Marie Curie Glasgow, we were given timescales for reporting back on that work. Perhaps in closing with petition, it might be useful for us to send that reference to the petitioner. I am interested in the petitioner's comment that the danger may be that respite care is lost in the focus, and that is the primary objective of my petitions. I am not entirely clear, because I have not been here all the time. The petitions that are being dealt with seem to be expressing concern that we have only focused on palliative care, whereas respite care presumably could apply to people in a much wider range of people. There is an issue in Lothian at the moment about respite care being taken away from people who used to use a unit called the LANFINE unit. I have certainly had a constituent who has lost his respite as a result of that. Lothian would argue that every model of the service, but the fact of the matter is that some people have lost out. That is the kind of dimension that is coming to me at the moment. I have not been closely involved with the petition, but I do not think that there is probably any option to closing it at this stage. However, it may be that we have not quite captured the breadth of the concern of the petitioner by focusing on palliative care rather than on the broader kind of respite issue that is being raised. Fiona Hysliffton My recollection from the evidence that we heard from Cabinet Secretary for Officials last week was that it was also about respite care and that they gave us time scales for reporting on those pilots. Rhoda Rennart Just to make the point that children's hospice care is very different from adult hospice care. It is about respite. It is about the fact that we are having young people grow up in the children's hospice movement probably from birth on to when they are leaving in adulthood. That support is really important to them, not just for their families for respite but for themselves socially so that they can do what they want to do without having them being dependent on their families and then they come out into an adult system, which is a totally different palliative care. It is about very much at the end of life rather than for life-limiting conditions. I think that there are concerns here and I would not just like to be seen to tick the boxes if sorted. I think that there will be on-going issues. That is why I would be keen to get the petitioners' views to feed that into the process. I might have been with a better position if we agreed that we would deal with this petition in our evidence of palliative care. We are slightly suggesting that that should be different at this point. Although it is on that focus of palliative care, Mary Curie and Chas, that was the process that we were going along. We decided to deal with this petition as we took evidence on palliative care at the end of life care. Chas is directly involved with this. It is about what a committee is expected to do with a petition. I think that, as a committee, we agreed that we would deal with this and suggested that to the petitioner and let him know that in our general evidence with palliative care. The issues that were raised in the petition were raised directly with the cabinet secretary. Chas is directly involved, and Mary Curie is directly involved. I just feel that we are maybe not objecting to it, but I would not want to give the petitioner a false expectation that we are going on another route here. I think that we have approached it as consistently as we possibly could. We informed the petitioner that that is what we are going to do, and it was a focus on palliative care. The people who are directly involved are able to deal with the issues through the pilot and others. I do not know, other than either coming off the parameters that we were falling to deal with this. You are suggesting now that it was not just about palliative care, it was about life-long conditions. We did not approach it like that. You could ask for the indulgence. We want to leave it live for a couple of weeks, but we need to know what we are discussing in the next couple of weeks. The petitioner is going to respond to his petition and is making it. I do not know where we are going. It is not life-long conditions as such. It is life-limiting conditions. What we have got is conditions where children would not have reached adulthood if they suffered from in the past are now living beyond that because of advances in medicine. There is a gap for people who have had that kind of support in their youth and are not getting that support going forward. I know that we cannot keep the petition open and I know that we agreed to deal with it that way, and I know that the Government is trying to do something about it. All that I am suggesting is that we get the petitioner's view and feed it into Government, because I think that that is important when you are piloting something and not keep the petition going. I first heard about the on-going situation at Chaz during the cross-bartic group on muscular dystrophy. The particular group of people is the Duchenne muscular atrophy and people who are finding the arg now surviving into adult life. I think that what Rhoda has said is exactly right. They need respect. Ultimately, they may well need palliative care as well, but the respite was quite a significant part of what was said. I think that the petition, if I remember, arose from one of those people, if I remember correctly. I suppose that what I am struggling with is that once the petition comes to the audience, we progress it. Of course, we communicate and we let the petitioner know what we are doing with it, and it is about how we have dealt with it that I am focusing on. One of our recommendations—the committee welcomes a joint work with the Scottish Government on Chaz and is currently undertaking to look at how respite services for young adults can be improved and increased. I think that Chaz has commented on the importance of respite and our report. The petitioner's concerns have been addressed by the committee in its report, in its recommendations and in its evidence-taking. I do not know what more we can do when we have a response for the cabinet secretary or what is going on and the pilots are taking place and it has been looked at with consideration. Of course, people can make representation to that. I agree absolutely with what you are saying, convener. I was greatly reassured by what the cabinet secretary was saying, but I wonder whether it would help, given that we are going to be discussing our legacy paper later on in today's meeting, to let the petitioner know that that is something that we can look forward to the work that is going forward on this general issue, including respite, and that it is something that we can ask our successor committee to revisit or monitor at some appropriate time in the future. If that would give some reassurance to Rhoda and to Nanette, as well as to the petitioner. I think that the committee has done a good job on this. We are in their situation well. We are almost in Nanette. That is something that we should close the petition. I do not think that there is any point in keeping the petition open, because we have done everything that was asked of the petition. I quite like Mike's suggestion that we do just put it as a small part of our legacy paper. If the petitioner wants to make comment to the Scottish Government, the petitioner can make comment to the Scottish Government. As agreed at the previous committee, we now move to a private session. As I said, I suspend the meeting at this point to clear the room.