Select Committee on Health Written Evidence

116. Evidence submitted by Seton During (PPI 24)

What is the purpose of patient and public involvement?

  1.  To praise where due and notify about strengths, weaknesses, errors of omission and commission about any and all aspects of health services provisions and deliveries, and, if capable, recommend optimisations.

What form of patient and public involvement is desirable, practical and offers good value for money?

  2.  Good starts are existing variegated forms of PPI Forums as credible workable imperfect foundations.

Why are existing systems for patient and public involvement being reformed after only three years?

  3.  Because Central Government and Parliament are congenitally wasteful, and in these respects have nebulous senses of purpose and direction, poor value judgements, and lack the moral courage to publicly confess what they really want.

How should LINks be designed, including:

  4.  For optimum economic management of changes, start with all existing PPI Forums; optimise from a central generic "guide"" to sustain continuities and accommodate changing local desired objectives variegatedly with a sharper lookout for fraudsters.

Remit and level of independence

  5.  As currently applicable to/for existing PPI Forums.

Membership and appointments

  6.  As currently applicable to/for existing PPI Forums with better diversities, a sharper lookout for commercial lobbyists; and, enhanced criminal records burueau checks certification.

Funding and support

  7.  As currently exist—with less expensive top-heavinesses and no more.

Areas of focus

  8.  As currently exist as foundations for enhancements/innovations, eg hygiene; better education; diseases of the young (STDs); mycoplasmas/man-made diseases—AIDS/HIV; medical errors; educated utilisations of feedback from pathologies; adverse(-side) effects approved drugs; non-NHS/private practices; excessive unethical monopolist influences of pharmaceutical multinationals; better regulations with governmental oversight of integrated/alternative/complementary medications-practices-sales; effective oversight of food-chain(farms/imports to grocers), protections of NHS staff from assaults and abuses, Spending efficiencies, etc.

Statutory powers

  9.  As currently for PPI Forums but more powers of inspections—preferably unannounced for effectiveness—for all areas including clinicians, ordering/purchasing/spending efficiencies, management accounting with radical departures from current complacent auditing towards instituting the audit function as an aggressive management tool for economic optimisations in the absences of credible empirical formulae for performances measurements, eg profitability, rates of returns on capital employed and/or capital employed plus recurrent revenues within fiscals.

Relations with local health Trusts

  10.  This must be statutorily encouraged to counter uneconomic duplications, gaps in local provisions, and contribute better within the organogram, particularly for the specialists as well such as Mental Health, Ambulance, etc.

National coordination

  11.  My experience being limited to London, I suggest leaving things as they are with the present London Network of PPI Forums, and, the present reference group of The Healthcare Commission—both deficient in diversities, eg the young, and, races.

How should LINks relate to and avoid overlap with:

Local Authority structures including Overview and Scrutiny Committees

  12.  Statutorily Distinct-Separate-Autonomous with reciprocal co-options but without voting rights to avoid politicisations of LINKS. Our own OS&C here in Enfield is not value-for-money, ineffectual, patronising, and highly cosmetic.

Foundation Trust boards and Members Councils

  13.  I would recommend an urgent interim body comprised of Association of Local Government/Authorities, The Chartered Institute of Public Finance and Administration, NHS Executive, HM Treasury, The Confederation of British Industry, The Institute of Directors, The Trades Union Congress, Useful Non-Political Peers, a sprinkling of individuals to be selected exclusively by The Head of The Home Civil Service, must be assembled with a wide-ranging remit to introspect these and feedback their recommendations initially excluding MPs and Councillors inputs.

Inspectorates including the Healthcare Commission

  14.  For reasons of credibility, ethics, and protection from bullying, I would prefer a unique inspectorate outside of and not controlled by the Healthcare Commission, so, suggest within The Audit Commission.

Formal and informal complaints procedures

  15.  To remain as they are—Trusts must never be final arbiters for historical and obvious reasons.

In what circumstances should wider public consultation (including under Section 11 of the Health and Social Care Act 2001) be carried out and what form should this take?

  16.  Whenever deficiencies or major statistical errors of omission/commission are reported or suspected: consultations processes to be exploited should include press, radio, television, internet, central government (Health, Inland Revenue, Social Security etc), local authorities etc databases, etc.

  I submit all above as an individual and would be prepared to answer The Parliamentary Health Committee questions in public if required.

Seton During

London Network of Public and Patient Involvement in Health Forums

[comments are made as an individual]

12 December 2007

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