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Paper 9 -  30 November 2001Meeting


30 November 2001


Report by the Policy Manager



(1) That the joint response be noted; and

(2) That the Chief Executives’ Group report further at the next consultation stage.

1. At the last meeting, Members considered the Department of Health’s discussion document "Involving Patients and the Public in Healthcare". It set out the Government’s plan to replace the Community Health Councils (CHCs) with:

* Patients’ Forums

* Bodies called "Voice" - A "Voice" for Hampshire and the Isle of Wight was proposed, possibly to be located with a "host" local authority which would employ "Voice" staff.

2. The discussion document gave only broad outlines of the new system. Local authorities will have new powers for their overview/scrutiny arrangements to scrutinise the NHS. There will be a formal consultation process in the next few weeks on these proposals.

3. Following the critical response by Association members, I agreed a joint response with the lead officers (Terry Butler and Chris Tapp). This response (given in the Annex) was submitted by the Government deadline for the "listening period" in October. A number of member authorities submitted their own responses. In particular the Isle of Wight was not prepared at this stage to sign up to aspects of the joint response.

Policy Manager

Date: 12 November 2001
Annex: 1
Contact: Nick Goulder - 023 8068 8431, E-mail hiow@eastleigh.gov.uk


Involving Patients and the Public in Healthcare

Final response from the local authorities in Hampshire and Portsmouth

1. We welcome the aims of the proposals to involve both patients and the wider public in the NHS. However we are concerned that:

* the scale of the re-organisation is too great, especially at a time when so many other changes are under way

* the complexity of the proposals may be such as to defeat the object of greater involvement. The NHS Plan makes it clear that the object is also for the system to be easy to understand.

2. For patients, particularly those who are marginalised, a very clear and straightforward "way in" is needed. At a time when the managerial structures are being radically overhauled we question the wisdom of proceeding to change completely the public and patient representation system.

3. The structure proposed is in danger of being particularly complicated where local authority boundaries and NHS Trust catchment areas are not co-terminous, where unitary authorities’ boundaries only cover part of the NHS Trust area, or where the local authorities need to work together across two-tier areas. This applies to most of the country and to this area.

4. The proposals seem to have been drafted with metropolitan areas in mind. It is extremely important to make clear how the local authorities which partner Primary Care Trusts (principally District Councils in two-tier areas such as Hampshire) will deal with the scrutiny process.

5. Arrangements should also be made to ensure that the Voice operates at the District Council/PCT level.

6. Having said this, the local authorities in the area of the proposed Hampshire and Isle of Wight Strategic Health Authority will collaborate to make any new system work. We welcome the proposals for local democratic input to the NHS via the scrutiny process. We will work together to ensure that this process is a positive force for change. We will tie in these arrangements to those currently being established for Local Strategic Partnerships.

7. We welcome the proposal for local authorities to host the "Voice" staff and we re-iterate the need for local "mini-voices" in two-tier areas.

8. We will work together to ensure that the proposals, if implemented, will not appear too bureaucratic or become too expensive. However there is serious concern at the potential cost of the system. We ask that the Government costs out these proposals before proceeding to implement them and states how the costs are to be met.

9. In order to achieve some continuity, retain local credibility and avoid excess costs, it will be important to use and build on existing Community Health Council experience

Note: this response has been prepared through the Association of Hampshire and Isle of Wight Local Authorities based on expert opinion from many different quarters during the Government’s "listening period".

Last update: 21/11/2001
Author: Nick Goulder, Policy Manager

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