Examination of Witnesses (Questions 20-39)
17 SEPTEMBER 2003
JOHN ARCHER,
CHRIS APPLEBY
AND GAIL
RICHARDS
Q20 Dr Pugh: Can I ask about your
trust boards? Are 14 per cent of the trust boards from the ethnic
minorities in each case?
Ms Richards: A bit higher. The
numbers are low but we are higher. Again, we have such a number
of communities I would not say that we were fully representative
of all ethnic communities.
Mr Appleby: We have one out of
five, so it is 20 per cent.
Mr Archer: We have one out of
ten but that is covering all these different boroughs.
Q21 Dr Pugh: So broadly it is what
you would expect, if not a little bit better. What about contractors?
You are big providers of services. You commission a lot of work
to be done on your grounds and so on across the borough. We have
not seen much evidence that the Asian community provides bread
and butter services to the health economy.
Ms Richards: We have a very small
estate team, we have created apprenticeship schemes in partnership
with the Groundwork Trust. In our big initiative, the LIFT initiative,
which we are in the middle of the procurement phase for, we have
made a number of issues related to community cohesion part of
our key local criteria for assessing our preferred bidder, so
that will start to change from next year.
Q22 Dr Pugh: That comes into the
tendering arrangements?
Ms Richards: Yes, it does. It
is one of the criteria and it relates to providing local employment
and commitment to equality, yes.
Q23 Dr Pugh: Does that apply to the
other trusts?
Mr Appleby: Yes. The trust has
a policy of using local contractors where possible. We are probably
in a slightly different position in that we merged just over a
year ago, so we are probably putting less out into the community
and doing more internally as we are bringing together departments
across what were previously four trusts.
Q24 Dr Pugh: Can we be quite clear
that your bias is in favour of local contractors but not from
any one specific ethnic minority?
Mr Appleby: Local contractors,
yes.
Q25 Chairman: What about incentives
for senior management to live locally?
Mr Appleby: Incentives in terms
of a policy by the board, do you mean?
Q26 Chairman: Yes. If you take the
Oldham borough, that goes back a long time but there was a period
when in the old government borough any senior officer had to live
within ten miles of the town hall. It obviously makes a lot of
difference if people live locally. They are likely to see problems
rather more. They spend their salaries locally. One of the problems
in the town is poverty, so what we need is more money coming in.
Is there a direct policy to encourage people to live locally?
Mr Appleby: There is a policy
to encourage people to live as locally as possible but it is slightly
different for us because, of course, we are Pennine Acute which
covers Bury, Rochdale, Oldham and North Manchester, so it does
not just affect Oldham. If you look at where we draw our management
team from, it is a fair spread from those four previous trusts.
The headquarters happens to be in Oldham but that is just for
administrative ease. It could be on any of the other sites.
Q27 Chairman: Yes, but there is an
incentive for people to live within the catchment area.
Mr Appleby: There is encouragement
for people to do it, mainly because we require them to be on call.
Mr Archer: There is a requirement
for consultants to live within 12 miles of where they are going
to be based, but from the trust perspective nine out of ten people
live within the borough.
Q28 Mr Clelland: Can you tell us
what type of training in race relations and racial equality staff
receive?
Ms Richards: As a new organisation
we are still accessing the training and education that is available
from the predecessor organisation. We have reviewed that and we
have put in place an action plan to ensure that we take forward
"positively diverse" across the organisation. We have
now recruited an education and training lead to take that forward
within the organisation because we recognise that, whilst the
staff did have access to equality and diversity training, not
just in relation to employment but in relation to playing a part
in the borough, it was a bit piecemeal. We will be commissioning
a company later in the year and two of our HR staff are now trained
in "positively diverse" to bring that in across the
organisation. If you were to ask me the question in a year's time
I would be able to give you absolute assurance that this is a
whole organisation programme, not piecemeal.
Mr Appleby: We are in a similar
position, that people have been receiving equality and diversity
training in all individual trust bases, which is on a site basis.
That has continued until recently, although we have submitted
some evidence in terms of what we have done in terms of trying
to bring that together. One of the things that we have just arranged
to do is put all the trust board through that training because
we think that will set a good example in terms of trying to cascade
that down through the organisation. What I do not want to do is
set it up centrally and find that we are getting less training
because of that. If it has worked locally then I do not want to
change something just for the sake of changing it.
Mr Archer: That training will
be mandatory. For everyone within the trust it should be achieved
by the middle of next year.
Q29 Mr Clelland: To what extent does
this training include training in social cohesion as opposed to
training in equality and race relations?
Ms Richards: Certainly from our
point of view we took a paper to our board a couple of weeks ago
and it was supported that the work around taking forward the action
plan for the racial equality scheme which included training and
education became an integral part of our work on fairness, equality
and diversity, so it is certainly something that we are considering
but, as I say, we have not put ours in place yet.
Mr Archer: What has been very
helpful to us is that in all of the boroughs we are integrating
management arrangements with social services so we function as
one unit. Social services have traditionally done far better than
the health service on this type of training, so they are really
helpful in making us think afresh about what we want to do. That
has helped us enormously.
Q30 Mr Clelland: What effect has
the Race Relations Act 2000 had on your organisation?
Mr Archer: There are targets that
we have to meet that we are monitored against, so all of our human
resource departments have had to construct strategies that are
closely monitored in terms of their performance against those
targets.
Q31 Chairman: Mr Appleby, do you
want to comment on that?
Mr Appleby: No. I would agree.
Q32 Chris Mole: Ms Richards, while
we have got you here, you chair the Local Strategic Partnership.
What is that partnership's role in community cohesion?
Ms Richards: Huge. We can talk
the talk around what we are trying to achieve as the Local Strategic
Partnership which is truly trying to pool everything we are doing
for the benefit of the local community, whether it is resources,
whether it is people time, whether it is the number of times we
ask the people out there the same questions. We want to pull it
together across all the sectors that work in the borough, recognising
that everything that is done through the sectors (including the
voluntary community sectors) impacts on how much people feel valued,
feel part of a community, are enabled to build positive relationships,
feel that their different cultures and backgrounds are valued.
It is inextricably linked with the work we do. Where we have got
to is that the commitment is real, and I think that was tested
yesterday at the conference that you came to, and that is beginning
to be reflected back. As with all these things, the proof is in
the pudding and the area planning process that we are taking forward
that gives us the opportunity to do that because we are demonstrably
getting closer to communities, understanding their issues, but
also developing services and initiatives across the whole borough
that reflect what we are hearing and what we are saying in a way
that has not happened before.
Q33 Chris Mole: You touched on not
asking the same people the same questions. In what way does the
Local Strategic Partnership engage creatively in these neighbourhood
communities?
Ms Richards: I do not want to
overstate this, but through the work that is being done by building
up views from within the schools and engaging young people and
then testing their views in some of the ways that the Local Strategic
Partnership, and the Oldham metropolitan borough who have commissioned
them, they are hugely creative in their approach, using art and
drama in a range of things; and, secondly, by linking in with
the existing groups that are out there. It has struck me particularly,
coming over the Pennines, that in Oldham there is a huge commitment
to volunteering and there is an awful lot of really good work
and a whole range of community initiatives here, so instead of
sitting and commissioning something behind the scenes, we are
getting out and our staff are directly working with the Local
Strategic Partnership partners and with those community groups.
Q34 Chris Mole: Given that there
is a plethora of other partnerships, and no doubt the Local Strategic
Partnership has a few sub-committees, how do you make sure that
what you are doing is turned into action rather than just more
words?
Ms Richards: Two things. First,
by having a framework that means that all of the partnerships,
including the Community Cohesion Partnership, (a) are reflective
increasingly of the local community, and (b) are linked directly
to the Local Strategic Partnership; by having a very small core
co-ordinating secretariat, which is again my personal preferred
way forward because that ensures that all of the key players in
the town have to keep coming to the table. You cannot say, "Oh,
it is that office over there that will take this work forward".
Sorry—I have forgotten the question.
Q35 Chris Mole: It was how you make
sure that what you are doing is turned into action.
Ms Richards: The community strategy,
pulling that together very rapidly last year, ensuring that that
now reflects the area plans, but within that what we are using
is the new performance framework for Local Strategic Partnerships
which very much puts the emphasis on not just, "Are you all
beginning to get on together and truly talking over and tackling
difficult issues?", but also, "Is this making any difference
at all in the town?". We are using that self-assessment tool,
we use it through the community groups and we ask them to give
us the feedback, and obviously Government Office North West and
others scrutinise us at every meeting and give us feedback.
Q36 Chris Mole: May I ask all of
you how the health sector has been involved with the Single Regeneration
Budget work and do you think this has been an effective way to
tackle community cohesion and bring about regeneration?
Mr Appleby: I wanted to pick up
on something that Gail talked about. You ask how we make sure
it becomes real. We are picking up on some of the work that the
Local Strategic Partnership is doing in terms of schools. We touched
briefly on employment. For me the employment issue, in the way
that we relate to the local communities, is enormous. Pennine
employs 10,500 staff, approximately 2,500 in Oldham. Again, I
am an incomer from over the Pennines and it struck me that we
import staff from different parts of the country, from different
countries and yet we have a resource here which I am not sure
we are tapping into. We need to get them into the very early stages,
much earlier than historically we have, and so in this work that
Gail is talking about we want to try and get people to make choices
early about what they want to do in terms of training and so on
and pulling them in. We have enormous skill shortages in nursing,
paramedics and so on, and it seems to me that it is an opportunity
to do that. There are some real examples where|
Q37 Chairman: The cynic in me would
say that you are trying to grab the Single Regeneration Budget
to meet your training needs.
Mr Appleby: But I do not think
there is anything wrong with that, particularly if it is mutually
beneficial.
Ms Richards: My take on the SRB
is that we have recognised both the advantages and the risks.
We have been able to use it to pump prime very specific initiatives
but we have recognised the concern that (a) it has only benefited
certain parts of Oldham and that has caused awkward issues that
you are aware of it, and (b) it is time limited. It can be what
I call rather disparagingly "hit and run funding". What
we have done by pulling together a three-year health and social
care strategy under the Local Strategic Partnership is that we
have funded those initiatives that have had a demonstrable impact
(a) with mainstream funding and (b), to take the example of Sure
Start or the Cottoning On initiative (and you have had evidence
on that), we are rolling out that practice across Oldham. Time
limited resource has its place if it is used wisely and if you
know at the outset that you are in a position to sustain it and
ensure everybody benefits.
Q38 Chairman: Mr Archer, do you want
to get a word in?
Mr Archer: Within mental health
it is crucial that we somehow mesh all of these targets. Within
the national service framework, which is seven targets in five
key areas, one of the areas was around health promotion, social
inclusion, under-employment. Other targets were about making sure
we take care of people with serious mental illness appropriately
and improve hospital beds and everything else, and I suppose we
are all looking for investment in targets that are closer to our
hearts. I do think in Oldham over the last year especially we
have seen some benefits from regeneration projects and I think
they are bearing fruit. As I said, from the mental health viewpoint
we are feeling much more included. We are starting to see some
evidence of change. We are starting to feel that there is some
greater investment in it. It has felt very positive.
Q39 Dr Pugh: Your organisations have
been running and supporting a number of projects promoting social
cohesion. Which have worked the best and why, and which would
you like to see most sustained?
Ms Richards: I would say it is
the project that we are just embarking on, which is the LIFT initiative,
which enables us to create a whole range of buildings which will
truly provide community based facilities and be managed and designed
by and with communities. Although the building does not start
till February it happens very fast so we have demonstrably responded
to people's needs, but the early engagement during this last year
has brought together a wide range of people. What they are saying
to us is that they are beginning to feel listened to, and because
LIFT enables us to respond very fast people can see change happening
whereas there is still a sense of, "We have been round this
loop before and things have not happened".
Mr Appleby: I would not disagree
with that. The thing that is going to have the biggest impact
on health in Oldham and the biggest impact on my service is investment
in primary and community care. That is a good example.
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