Hansard

The Convener Lab

We move to agenda item 2, which is oral evidence on one negative instrument. The instrument gives Healthcare Improvement Scotland the power to direct health ...

Maureen Watt SNP

Thank you for providing me with the opportunity to explain the rationale behind the Healthcare Improvement Scotland (Delegation of Functions) Order 2016. Tac...

The Convener Lab

Thank you, minister.

Rhoda Grant Lab

The minister has said that she does not believe that the power will be used often. In what circumstances does she see it being used? What will the process be...

Maureen Watt SNP

The powers will be used only in unusual situations. There are powers in the National Health Service (Scotland) Act 1978 for ministers to take action when cer...

Robbie Pearson (Healthcare Improvement Scotland)

We are clear that Healthcare Improvement Scotland’s role sits within a broader escalation framework. That framework is in place ahead of the powers and is us...

Rhoda Grant Lab

Closing a ward to new admissions makes sense if it is for infection control purposes. Those who might already have been infected would be isolated and not mo...

Robbie Pearson

If the concern was about ward staffing levels, a reduction in the number of admissions to that ward would clearly be beneficial, as the cohort of available s...

The Convener Lab

We are not necessarily aware of the range of areas that fall into the category of a serious risk to life, health or wellbeing. We have established that there...

Maureen Watt SNP

An example would be a theatre in which someone notices that cleanliness is not up to standard. Do you want other examples?

The Convener Lab

So we have theatre situations, staffing levels and mix, and infection.

Robbie Pearson

One example would be extreme pressure at the front of a hospital from the number of A and E attendances and patients requiring to be seen in an assessment un...

Jacqui Macrae (Healthcare Improvement Scotland)

That is the only other example that I can think of. I reiterate that our general experience is that boards take immediate action to resolve such issues and ...

The Convener Lab

The issue is the power that the order gives HIS. I can see a ward being closed to new admissions when there is an infection. I can see a decision to close A ...

Maureen Watt SNP

The order has been made because one of Lord MacLean’s recommendations in the Vale of Leven inquiry report was that the Scottish Government should ensure that...

The Convener Lab

A wider point is about whether Healthcare Improvement Scotland is a regulator or a part of the health service. Was Lord MacLean getting at that?

Robbie Pearson

A broader consideration of Lord MacLean as chair of the inquiry was that additional powers were not needed, beyond those in the first recommendation. The inq...

Rhoda Grant Lab

I am not totally satisfied with the answer to my previous question about staffing numbers being seen as unsafe for patients. Closing a ward to new admissions...

Maureen Watt SNP

Hospitals already deal with that issue. As we have stated, a norovirus outbreak can affect not only patients but staff. That is why a ward would be closed to...

Rhoda Grant Lab

What powers does the order provide to increase staffing levels, rather than just stop admissions, to deal with patient safety concerns?

Maureen Watt SNP

That would be discussed with all the partners who are involved because, as we have said, the decision would be taken not by HIS alone but by HIS in conjuncti...

Ailsa Garland (Scottish Government)

The order is restricted to simply giving HIS the power to give the direction to close a ward. I understand that the escalation procedure involves discussing ...

The Convener Lab

Mr Pearson, will the order give you greater power in your relationship with health boards to get quicker action? Will it help in that discussion or negotiation?

Robbie Pearson

Yes. The order allows us a degree of direction, formality and legal power that we do not have at present. The important point is that that does not take away...

The Convener Lab

Mike MacKenzie has a supplementary question.

Mike MacKenzie (Highlands and Islands) (SNP) SNP

Mr Pearson, you mentioned that an algorithm would be used in the decision-making process. That thought fills me with concern. Will the decision be made by a ...

Robbie Pearson

I assure the committee that the algorithm is not some remote computer-generated yes/no answer. It will be informed by clinical and professional judgment on t...

Dennis Robertson SNP

Mr Pearson has just pre-empted my question, but I seek clarity with regard to single rooms. A ward may be comprised of a number of single rooms. Rather than ...

Robbie Pearson

That is an important point. In new hospitals such as the Queen Elizabeth university hospital, which has single rooms, the response is different from the resp...

Jacqui Macrae

It is very much about the individual context. We should bear in mind the timescales within which things might happen and how the decisions would be taken to ...