Mr. Peter Tyndall:

I want particularly to comment on the issue of direct provision and will comment later on the cultural diversity issue. I am on record as saying, as is my predecessor, that some of the most vulnerable people in our communities do not have access to proper independent redress. This must be a matter of concern for this committee and people in general. I believe this needs to change and I will continue to make the case for change in this area. Where people are denied their rights because they are not citizens of a particular country and are, because of this, living in circumstances over which they have very little influence, this is where the demand for independent redress should be highest. It is unusual across Europe for people in these circumstances not to have access to the national ombudsman. I do not believe that is right and it should change. My views on that are unambiguous.

On cultural diversity, I am conscious of the issues around cultural diversity, including the different traditions of dealing with death in terms of mourning, burial and so on. This has not featured particularly in the complaints to my office. However, it is an issue we would be alert to. The complaints we receive relate more to the increased numbers of people dying in hospital as to opposed to elsewhere. One of the most remarked upon features of hospitals is the age profile of their populations. Very high proportions of people in hospital are in their eighties and increasing proportions of people in hospitals have dementia and other conditions associated with ageing. A consequence of this is that the demands placed on clinical and nursing staff in particular are very different from what they were in the past. I am not convinced that in producing our nursing and clinical staff for the future we have reflected the changes in the nature of the job they will be asked to do in our acute hospitals. I intend to have conversations around this with the bodies responsible for clinical staff in the health service. It is important I have conversations with them as a matter of course but these are areas I will want to explore with them.

In a sense, this report also gives me the basis for a conversation with those who are committed to producing our future doctors and nurses around the issues that need to feature more in training than was necessarily the case in the past.