Minutes of the Previous Council Meeting held on Wednesday 1st November, 2006

Minutes of a Meeting of the Council of the City of Sheffield held in the Council Chamber within the Town Hall, Sheffield, on Wednesday, 1st November, 2006 pursuant to notice duly given and Summonses duly served.

PRESENT

THE LORD MAYOR (Councillor Jackie Drayton)

THE DEPUTY LORD MAYOR (Councillor Arthur Dunworth)

1 Arbourthorne Ward	10 Dore & Totley Ward	19 Mosborough Ward
Tim Rippon	Anne Smith	Sam Wall
Julie Dore	Mike Waters	Mike Peat
John Robson		David Barker

2 Beauchief/Greenhill Ward	11 East Ecclesfield Ward	20 Nether Edge Ward
Clive Skelton	Graham Oxley	Ali Qadar
Anthony Holmes	Vic Bowden
Simon Clement-Jones

3 Beighton Ward	12 Ecclesall Ward	21 Richmond Ward
Helen Mirfin-Boukouris	Roger Davison	Liz Naylor
Ian Saunders	Sylvia Dunkley	Martin Lawton
Chris Rosling-Josephs	Michael Reynolds	John Campbell

4 Birley Ward	13 Firth Park Ward	22 Shiregreen & Brightside Ward
Mike Pye	Alan Law	Peter Rippon
Bryan Lodge	Joan Barton	Jane Bird
Denise Fox	Chris Weldon	Peter Price

5 Broomhill Ward	14 Fulwood Ward	23 Southey Ward
Paul Scriven	Janice Sidebottom	Gill Furniss
Alan Whitehouse	John Knight	Tony Damms
	Andrew Sangar	Leigh Bramall

6 Burngreave Ward	15 Gleadless Valley Ward	24 Stannington Ward
Steve Jones	Garry Weatherall	David Baker
Ibrar Hussain	Terry Fox	Vickie Priestley
	Rosemary Telfer

7 Central Ward	16 Graves Park Ward	25 Stocksbridge & Upper Don Ward
Bernard Little	Peter Moore	Alison Brelsford
Jean Cromar	Ian Auckland	Martin Davis
Jillian Creasy		Martin Brelsford

8 Crookes Ward	17 Hillsborough Ward	26 Walkley Ward
Sylvia Anginotti	Janet Bragg	Jonathan Harston
Brian Holmes	Robert MacDonald	Diane Leek
John Hesketh	Alf Meade	Veronica Hardstaff

9 Darnall Ward	18 Manor Castle Ward	27 West Ecclesfield Ward
Mazher Iqbal	Jan Wilson	Trevor Bagshaw
Mary Lea	Pat Midgley	Kathleen Chadwick
Harry Harpham	Jan Fiore	Alan Hooper

		28 Woodhouse Ward
		Ray Satur
		Marjorie Barker
		Mick Rooney

1.	APOLOGIES FOR ABSENCE
	Apologies for absence were received from Councillors Patricia Fox, Keith Hill, Bob McCann, Andrew White and Pat White.

2.	MINUTES OF PREVIOUS COUNCIL MEETINGS
	RESOLVED: On the motion of Councillor Pat Midgley, seconded by Councillor Jean Cromar, that the minutes of the meetings of the City Council held on 29th September and 4th October, 2006 be approved as a correct record, subject to the substitution of Councillor Alf Meade in place of Councillor Andrew Sangar in the list of those recorded as present on 29th September and 4th October, 2006 representing the Hillsborough Ward.

3.	PUBLIC QUESTIONS AND PETITIONS
	Petitions
	(a) Petition concerning lettings policy
	The Council received a petition containing 117 signatures of tenants and residents of Westminster Crescent and Westminster Avenue and heard representations made on their behalf by Susan Richardson, expressing dissatisfaction in relation to the Council’s lettings policy which allowed people with a history of anti-social behaviour to move on to the estate, resulting in disruption and increased levels of stress for other residents and adversely affecting the quality of life in the area.
	In response, the Cabinet Member for Safer Neighbourhoods, Councillor Chris Weldon, indicated that the matters raised by the petition had been brought to the attention of the Sheffield Homes Local Board. He pointed to the need to enforce tenancy conditions with the support of Sheffield Homes and requested that the petitioner speak to him further concerning the details of the issues raised.
	The Council referred the petition for consideration by the Cabinet Member for Safer Neighbourhoods (Councillor Chris Weldon).

	(b) Petition concerning remarks made by Jack Straw MP
	The Council received a petition containing 526 signatures, deploring the remarks made by Jack Straw, MP concerning the veil worn in public by some Muslim women and calling upon the Council to distance itself from Mr. Straw’s comments and to condemn the Department for Education proposals to spy on Asian looking students.
	Maxine Bower addressed the City Council, accompanied by Mrs. Sabia and called upon the Council to make a positive statement to the Muslim community. She referred to fears expressed at increasing Islamaphobia and attacks on mosques in other areas of the United Kingdom. She also referred to concerns expressed by taxi drivers in Sheffield that they would not be able to drive in certain areas of the City because of anti-islamic feeling and to the role of the media.
	In response, the Leader of the Council, Councillor Jan Wilson, stated that Sheffield had a rich and diverse population and proud history of welcoming people into the City and that the cornerstone of a peaceful society was respect for one’s neighbour and this must include respect for peoples’ faiths and beliefs as well as respect for those of no faith.
	Councillor Wilson stated that we live in a democratic society where we believe that certain freedoms are a fundamental right and, in acknowledging our rights, we must promote a better understanding of all faiths and dispel the myths that may lead to divisions between communities. All groups in the community had a duty to work towards a more unified Sheffield so that barriers that stand in the way of cohesive communities can be removed.
	Councillor Wilson stated that recent world events had threatened to change people’s views about other groups within our communities and this made it more important to actively find ways of understanding and accepting diversity in culture and creed. The City Council as the elected body within Sheffield had a duty to promote the well being of the whole City and therefore it is the Council who should take the lead in bringing together communities to talk about how we could ensure that the Sheffield we leave for our children is a place where everyone in valued and respected and is as welcoming a city as we hope and believe it has been in the past. She stated that the Council would be asking communities how they could help the Council to achieve this.
	The Council referred the petition for consideration by the Leader of the Council (Councillor Jan Wilson).

	(c) Petition concerning the designation of housing in Stocksbridge
	The Council received a petition containing 1,410 signatures, calling upon the Council to stop using Stocksbridge as a rehousing area for problem tenants and for a proportion of flats to be redesignated solely for elderly tenants use. Marian Hutton addressed the City Council, stating that the allocation of new tenants who were not older people to housing in Stocksbridge adversely affected the quality of life of existing tenants who, in some cases, had been subject to intimidation which had been reported to both the Council and the Police. She called instead for there to be a change in housing policy to restore quality of life for people living in Stocksbridge.
	In response the Cabinet Member for Safer Neighbourhoods, Councillor Chris Weldon, stated that a meeting had been held, including a local Member, housing officer and himself in relation to this issue and that wardens had distributed letters to local tenants. 165 properties had been visited by wardens and no incidents had been reported as part of that exercise. He undertook to investigate the incidents involving threats and intimidation to older people and children brought to the attention of the City Council and emphasised the need to enforce tenancy conditions. He also stated that the majority of lettings in the area had been allocated to local people and that anti-social behaviour was not necessarily caused by those allocated properties in the area. He also stated that the lettings policy had been reviewed.
	The Council referred the petition for consideration by the Cabinet Member for Safer Neighbourhoods (Councillor Chris Weldon).

	(d) Petition relating to the use of Bocking Lane/Greenhill Avenue by Heavy Goods Vehicles
	The Council received a petition containing 221 signatures relating to the use of Greenhill Avenue, Bocking Lane and Abbey Lane by Heavy Goods Vehicles (HGVs) and heard representations on their behalf by Mr. Ken Newton who outlined concerns that these roads were essentially in a residential area and should be treated as a through road for HGVs. There were concerns in relation to health impacts resulting from increase use by HGVs and buses; safety concerns given the length, weight and width of HGVs; and what were considered excessive speeds in the early hours. Mr. Newton requested that HGVs be restricted so they could not use Bocking Lane and Greenhill Avenue.
	In response the Cabinet Member for Transport, Councillor Terry Fox, stated that the City Council did have powers as highway authority in relation to traffic management.
	The Council referred the petition for consideration to the City Centre, South and East Planning and Highways Area Board.

	Public Questions
	(a) Public questions concerning comments made by Jack Straw, MP and the Muslim community
	Jay Williams asked whether the Council was aware of Article 18 of the United Nations Declaration of Universal Human Rights which he believed Jack Straw MP had contravened in his comments regarding the wearing of veils by some Muslim women and he requested dialogue with Mr. Straw in relation to this matter.
	Angela Shann referred to plans by the Department for Education and Skills to spy on students in Universities and Colleges and expressed concerns at the suggestion.
	Alan Kenny asked when the City Council were to debate the war in Iraq and drew the Council’s attention to the impact of foreign policy and specific comments made by Jack Straw MP in relation to the wearing of veils by some Muslim women.
	In response, Councillor Jan Wilson referred to the previous statement she had made in relation to the petition submitted concerning the wearing of veils by some Muslim women.

	(b) Public question concerning traffic calming on Bocking Lane
	Fiona Bryant requested that traffic calming measures be installed on Bocking Lane and in the vicinity of Meadowhead. Pamela Hodgson asked for action to be taken in relation to signage on Abbey Lane, which directed traffic onto Bocking Lane and identified problems with HGVs on Bocking Lane mounting the pavement, thereby causing a danger to pedestrians in what was a suburban area.
	Carole Smith also pointed out problems in relation to the prevalence of HGVs on Bocking Lane and Greenhill Avenue and in particular the proximity of these vehicles to the frontage of properties and associated pollution.
	In response, the Cabinet Member for Transport, Councillor Terry Fox stated that these concerns would be referred to the relevant officers of the Council.

	(c) Public question concerning the future of non-traditional housing in Sheffield
	Jack Scott asked what the long term plans of the City Council were in relation to non-traditional housing.
	In response, the Cabinet Member for Safer Neighbourhoods, Councillor Chris Weldon, stated that there were plans to invest 4,930 of the 5,000 non-traditional properties in the City and for the 70 remaining properties, owners would be notified as to other mechanisms for improvements to properties. Local Members would be informed of those areas where there were not plans to invest and should assume that if they had not been informed otherwise, non-traditional housing would be subject to investment. The next step was to establish project groups to enable local people to have input into the process.

	(d) Public question concerning Blackamoor
	Dawn Byron referred to the use by Sheffield Wildlife Trust of cattle to manage vegetation on Blackamoor and a number of meetings held between the Wildlife Trust and users of Blackamoor. She stated that the employment of a site worker to manage the Moor and carry out conservation work would be beneficial, in place of cattle, presently used to manage vegetation. She asked whether the City Council could financially support the employment of a site worker.
	In response, the Cabinet Member with responsibility for Streetscene and Green Spaces, Councillor Bryan Lodge stated that he would speak to the questioner in relation to the matters raised.

4.	NATIONAL HEALTH SERVICES IN SHEFFIELD
	Simon Gilby, Acting Chief Executive, Sheffield Primary Care Trust, Chris Sharratt, Chief Executive, Sheffield Children’s NHS Foundation Trust and Chris Welsh, Acting Chief Executive, Sheffield Teaching Hospitals NHS Foundation Trust, attended the meeting to provide an update on health services in Sheffield.
	Simon Gilby, gave an overview of health services in the City stating that the population had witnessed an increase in life expectancy and a narrowing of the gap that existed between Sheffield and other areas in England. Targets established in relation to decreasing the occurrence of heart disease, strokes and cancers had been exceeded and there had been a decline in suicide mortality rates. There had also been a steady decline in deaths from circulatory diseases, between 1993 to 2006 and the trend was set out continue.
	Infant mortality in the City was higher than the national average and smoking prevalence also remained high and was thought to be strongly related to socio-economic deprivation. Deaths resulting from smoking and cancer were above the national average and there were significant health problems relating to obesity both amongst children and adults and substantially higher teenage pregnancy rates than those recorded as the national average. The City remained one of the most polarised communities in England.
	Simon Gilby pointed to information relating to average life expectancy in the City’s neighbourhoods, highlighting areas of particular concern. Public health initiatives had been well established and formed a strand of the Sheffield Area Agreement. In addition, there were enhanced public health programmes in 36 priority neighbourhoods in the City.
	Particular initiatives were outlined in relation to new services and improved capacity, the implementation of National Service Frameworks, investment in new treatments approved by the National Institute for Health and Clinical Excellence (NICE), increasing services and capacity in renal services and improving and redesigning services for people with long term conditions.
	A number of significant improvements had been achieved in relation to waiting times and access, including improved access to general practitioner services, waiting times in Accident and Emergency, for hospital services for cancer services. New assertive outreach services were being implemented in relation to mental health, crisis resolution, home treatment and early intervention services.
	A single Primary Care Trust (PCT) had been established in Sheffield on 1st October, 2006 and the Chief Executive designate of the Primary Care Trust would commence duties on 4th December, 2006. The Trust aimed to improve the health and well being of the population by commissioning high quality, responsive and efficient services within allocated resources and directly providing services where this represented best value. The population would be supported by a health spend of approximately £700m per annum.
	As a final strand of his presentation, Simon Gilby outlined close links between the Primary Care Trust and the City Council, represented by joint arrangements including Sheffield First for Health and Well Being, the Sheffield Area Agreement and initiatives such as the Partnerships for Older People’s Project, joint commissioning of mental health and disabilities services, the Children’s Partnership Trust and, most recently, the joint appointment of the Director of Public Health.
	As part of his presentation Simon Gilby referred to financial recovery measures by the Trust. No areas of weakness had been identified in relation to leadership, governance and control of the four Primary Care Trusts in the City as part of an external audit but he considered that the Trust had been overstretched by the pace of change in relation to the health agenda and had spent beyond its means. There was a requirement to achieve financial balance by 2007/08 and this would be made possible by reducing expenditure in all areas. By 2008/09 there was expected to be a recurrent surplus allowing for priority investments. As part of the financial recovery, all stakeholders would be engaged as part of a single financial plan for the City. It was also expected that the Trust would continue to achieve national priorities and meet nationally defined targets.
	As part of the (financial) Turnaround process, a savings target of £35.5m had been identified, of which some £12m represented as an additional challenge for the Trust beyond the plan identified at the start of the year, as anticipated central allocations were now unlikely to be made. In the year to date, the Trust were £2m ahead of projected levels of savings, although it was acknowledged that in the six months remaining to the end of the financial year there were particularly challenging targets in relation to savings.
	Simon Gilby outlined how financial balance would be achieved through service redesign including management of service volumes and reductions in excess bed days, length of stay and outpatient first follow-ups. Overall expenditure would be controlled.
	Simon Gilby concluded by summarising the primary aims of the Trust.
	The City Council then received a further presentation from Chris Sharratt, Chief Executive, Sheffield Children’s NHS Foundation Trust, outlining recent trends and performance in relation to services and other key developments. He outlined the Trust’s mission statement and information in relation to patient activity during 2005/06. There had been significant growth in relation to the number of outpatients seen by the Trust and in the numbers admitted for elective and emergency treatment whereby demand had increased by up to 23%.
	Chris Sharratt stated that all key targets had been met in relation to access to services, including reductions in waiting times for outpatients (to a maximum of 13 weeks), elective inpatients (maximum of six months) and a maximum 26 week wait for diagnostic tests. Targets had also been met in relation to waiting times for cancer services and the support of patient choice through e-booking.
	The Trust had achieved high standards of cleanliness and had one of the lowest rates of MRSA nationally. There was a high level of compliance with national health care standards and the Trust had achieved the highest score nationally in the Health Care Commission’s review of standards of care for children in hospital. Services were to be developed and these included paediatric neurology, paediatric gastorenterology and specialist orthopaedics and an expansion in outreach services in Barnsley.
	Chris Sharratt stated that the Trust was active in the Sheffield 0-19 partnership and in the development of forensic mental health services and the dual diagnosis national award. He also pointed to support for looked after children and the development of health assessment services and outlined other developments including a new day care unit, the development of intensive care, the expansion of theatres and of genetics services. The Trust also had a strong portfolio in relation to research.
	In relation to the financial position of the Trust, the Payment by Results regime had often proved inadequate for meeting the true costs of specialist children’s care. The Trust were also required to make efficiencies amounting to 4% per annum which equated to £9m over three years and Chris Sharratt referred to the Trust’s achievement as the most efficient provider of children’s service in the United Kingdom. Finally, the Agenda for Change reform and review of consultant contracts would have implications for resources which were not centrally funded.
	A third presentation was given by Chris Welsh, Acting Chief Executive, Sheffield Teaching Hospitals NHS Foundation Trust. He outlined outcomes during 2005/06, including the achievement of targets in relation to access to inpatient treatment, 13 weeks for outpatient appointments and three months waiting for heart surgery and that 99% of urgent referrals were seen within two weeks.
	There had been a 25% reduction in MRSA bacteriaemias and a £1m investment in hospital cleanliness.
	Chris Welsh reported other developments, including a £2.2m refurbishment of the Urology Department, £10.5m of investment in Renal Services and the foundations of the Sir Robert Hadfield Wing. The Trust had achieved a £602,000 surplus in 2005/06, a turnover of £612m, £397m of which related to salaries. The Trust had also achieved Hospital of the Year 2005.
	In 2006, the 62 day target for treatment of cancer from the first day of referral from the GP was being achieved in approximately 90% of cases and in accident and emergency, in 98% of cases patients were admitted within four hours. Recent developments included the building of the Critical Care Unit at the Northern General Hospital, the Physiotherapy Centre and the post operative surgical unit at the Royal Hallamshire Hospital.
	At the time of reporting the Trust had a £2.5m deficit, which equated to 0.8% of turnover at 30th September, 2006 and to bring this into balance an added value programme was being undertaken. Other issues affecting the Trust included modernising medical careers, including training and development for medical professionals, the implementation of the European Working Time Directive against the background of a culture of long hours in the National Health Service and improving outcomes guidance such as the increase in redirected services to Sheffield Teaching Hospital of cancer treatment and the challenge which this represented to the capacity of the Trust.
	The adding value programme represented £30m of savings each year over the next three years and areas of activity, which would be examined in order to achieve this would be considered. Such areas included capacity, i.e. to use all facilities efficiently so there was little downtime; to reduce the length of stay whilst not reducing the quality of service or pre-operative care, whereby most patients would be able to be admitted on the day of their surgery, provided the necessary preparatory work was undertaken; and savings in relation to the workforce which represented a significant challenge, given the proportion of the Trust’s budget which was assigned to employee costs.
	Following the three presentations, Members asked a number of questions relating to mental health services and community provision; public health provision; the Primary Care Trust’s financial recovery plan and the impact of the Turnaround Strategy upon social care; the outcome of the Health Care Commission Annual Health Check; and the utilisation of bed space in Ward S2 at the Children’s Hospital.
	Simon Gilby stated that, in relation to public health, investment was made wherever possible and work had been undertaken in partnership with the Active Sheffield iniative and in relation to the encouragement of healthy eating. There was particular capacity in relation to public health in plans for black and minority ethnic groups.
	The financial recovery plan had received a level of commitment support from partner organisations and he pointed to the need to properly manage demand in co-operation with organisations, such as health trusts and to address efficiency. In relation to the outcome of the Health Care Commission process, Primary Care Trusts had received a “weak” rating in relation to financial management, he stated that this judgment had been accompanied by a number of positive statements from the Health Care Commission. With regard to the assessment of “fair” in relation to the quality of services, he felt this rating did not fully reflect the wide range of services across the PCT.
	In relation to the impacts upon social care of the Turnaround Strategy it was the aim of the health service to work in partnership to ensure that people were taken out of acute services appropriately and as soon as possible and the Health Service and Local Authority were working together to manage the consequence of the drive for increased levels of community provision.
	Chris Sharratt stated that the S2 Surgical Ward now had 13 bed spaces and the Ward was being utilised in a more appropriate way than previously, with greater provision for day care. He emphasised that the S2 Ward was not closing and, in relation to the changing use of the Ward, the effect on patient care was assessed in terms of potential risk and quality of service. Questions were also asked in relation to the problem of obesity and the education of children in relation to healthy eating and concerning long term conditions and urology and endoscopy services particularly for people who found it difficult to access the Northern General Hospital site.
	Simon Gilby responded that obesity was a particularly challenging issue and it was the responsibility of the National Health Service to be proactive in relation to obesity, including working to increase levels of physical activity and the opportunity for people to participate in physical activity for example in relation the cost of such activity. He accepted that work with young people was critical to reduce the prevalence of obesity.
	For long term conditions, consideration was to be given to redesigning support for people with such conditions and to improve such support for them in their homes which would include approved training for clinical staff working in the setting of people’s homes and in other clinical settings outside of hospital, including GP surgeries.
	Questions were also asked in relation to whether there had a reduction in beds due to the reconfiguration of the S2 Ward at the Children’s Hospital; whether the sum earmarked for public health and allocated to Primary Care Trust was being used for that purpose; the extent to which the Payment by Results regime had contributed to the financial situation of health trusts in the City and whether the tariffs equated to the cost of medical procedures; did the numerous reforms of the Health Service, including that of the Primary Care Trust boundaries, distract from the concentration by managers and clinicians on the provision of health; did targets skew health care and health provision; and, in relation to patient choice had the existence of Independent Treatment Centres distorted the health economy in Sheffield?
	Chris Welsh stated that Sheffield Teaching Hospitals were subject to 26 individual performance targets and he stated that these did not skew clinical decisions. On the contrary, access targets for cancer services for example actually improved care for patients and did not adversely alter clinical priorities. The reconfiguration and reform of health services were not particularly significant at the clinical and patient interface and such re-organisations became increasingly significant at higher management levels of organisations. Recent reconfiguration of Primary Care Trust boundaries had not directly impacted upon the structure of the teaching hospitals but a change from the Trent to Yorkshire and Humber region made previously had affected the Trust.
	Payment by Results and the level of tariffs for medical procedures had not contributed to the present financial circumstances of the Teaching Hospitals Trust, although there were issues with certain tariffs. Tariffs encompassed a number of specialist treatments and secondary care and consideration was given as to how specialist treatments, which were more costly could be funded by the margin on other non-specialist procedures.
	Chris Welsh stated that the level of take-up by patients of services provided by the local independent treatment centre was disappointing and there had not been particularly large numbers transferring from the waiting list of the Teaching Hospitals in Sheffield. In relation to the S2 Ward at the Children’s Hospital, Chris Sharratt stated that consideration was given to the number of inpatient beds and it was concluded that more beds were required and work would be undertaken to create additional beds and meet demand. He reiterated that the ward would not close and the number of beds in the Children’s Hospital overall would increase along with the work undertaken generally by the Children’s Hospital.
	Chris Sharratt stated that the level of tariffs as they currently existed was a serious problem for the Trust and had contributed to financial pressures particularly for specialist services and there needed to be recognition that children represented a variety of needs and complexities in relation to medical procedures, for example, operations undertaken on babies had higher costs than those recognised in the tariff.
	In relation to the effect of targets, Chris Sharratt stated that if no target existed then services might be skewed, for example access to therapy services and those for people with a disability.
	Addressing the issue of public health, Simon Gilby stated that the budget for public health was not a single overall earmarked fund for the City and added that the City had a good track record in investing resources in public health. Those savings that had been identified across health services in Sheffield did not apply to public health and he recognised the need to increase work in relation to public health.
	He also stated that the development of one Primary Care Trust for the City was felt to be the right thing to do, although it was important not to lose the beneficial aspect of working at a local level, which the four former Primary Care Trusts had been able to deliver.
	The Primary Care Trust had a number of targets it was required to work towards both core and developmental standards and he felt that assessments of the Trust by an independent body such as the Health Care Commission were potentially positive.
	Addressing Independent Treatment Centres, Simon Gilby stated that in 2005/06 such centres provided additional capacity in relation to areas such as orthopaedic care and served to reduce waiting times. However, in 2006/07 not as many patients had chosen to be treated at the independent treatment centres and he felt that a key factor was the increasing quality of local NHS services and reductions in NHS waiting times.
	Further questions were asked by Members in relation to savings which might be made at a managerial level or administrative level with the reconfiguration of the Primary Care Trust; if there were plans to increase funding for alcohol treatment services in the City; the tariffs for specialist services; dental services; and the implications of implementing new computerised patient records.
	Simon Gilby responded that in relation to dental services Payment by Results would apply to such secondary care in time and there was a new contract for community dental practitioners which attempted to establish what a dental practice should provide for its population although these were in their first year and there was further work to do in the second year of the contract. There were a total of nine dental practices in the City taking new NHS patients.
	In response to a question concerning whether there would be compulsory redundancies in NHS Services, Simon Gilby stated that there were no plans for compulsory redundancies but that employees had been informed where voluntary redundancies were being considered. Questions were also asked in relation to whether early discharge of patients meant that they returned through the route of accident and emergency; the likelihood of financial recovery; whether people from black and minority ethnic communities were being employed or promoted to senior levels in the organisation and how this might be achieved; and in relation to cleanliness.
	Simon Gilby stated that the rate of re-admissions were monitored by the Primary Care Trust. It was necessary to manage financial issues in relation to the City’s trusts to achieve a balance. In relation to black and minority ethnic employees at a senior level, it was difficult to ascertain trends although there was an increase in the last year of the number of staff overall from black and minority ethnic communities and the proportion of people from black and minority ethnic communities as part of the total number of employees.
	Simon Gilby stated, in relation to a question concerning the introduction of limits on access to treatments for patients who contributed to their own ill-health or condition such as through smoking, that there were no plans to introduce such limits.
	Chris Welsh stated that the computerisation of patient records would have significant benefits for patients and the savings could be made as the cost of paper based systems was high. In the case of Sheffield Teaching Hosp