32. Evidence submitted by West Essex PPI
Forum (PPI 29)
PREAMBLE
1. The draft Local Government and Health
Bill includes provision for the abolition of Patient and Public
Involvement Forums on the basis, it seems, that Forums have not
achieved the full scope of local interaction envisaged, and that
when there are relatively few members there is a risk that personal
agenda may be pursued.
PROBLEMS OF
DICHOTOMY
2. As a Forum we have been aware of the
difficulties that arise at the interface between Health and Social
Care, with a division of responsibility and accountability which
may often be to the detriment of the patient or client. We would
therefore support measures to promote a seamless spectrum of care,
particularly for the aged. It is apparent that this is the motive
behind the creation of LINks, which are to be based on the administrative
areas of Social Services, which are effectively co-terminous with
County Councils.
The "devil", however, "is in
the detail" and there are features in the draft Bill which
we believe not only to be unnecessary but actually to be counterproductive.
PROPOSAL TO
ABOLISH PPI FORUMS
3. We firmly believe that the proposal to
disband and abolish PPI Forums is absolutely in the category of
unnecessary and counterproductive measures The preferred option
is to retain the new Forums with their existing statutory powers
and responsibilities, revise their terms of reference and incorporate
these Forums as integral to the core of the larger LINks.
BACKGROUND
4. PPI Forums were formed after the earlier
(and controversial) decision to abolish Community Health Councils.
The change over has been quite difficult in some places, except
where there was already in place an effective User Group. In Epping
Forest this was the case, but our first Forum Support Organization
went bankrupt and had to be replaced at short notice by a body
with no health service experience, which in turn had also to be
replaced. It took a good two years for our Forum to get "up
to speed" and our experience was by no means unique.
5. Important Differences from CHC's were
the removal of responsibility for individual patient complaints
and alignment with an individual Trust.The latter change, associated
with the Purchaser/Provider split caused some confusion and difficulty
in situations where both PCT and Provider Forums had a legitimate
interest. Cross communication and co-operation were essential,
but magnified the complexity and time involvement for Forum members.
As a result there has been considerable turn-over in membership
of many forums, but with Forum function reaching a steady state,
a nucleus of very dedicated individuals, quite often with some
relevant health related expertise, has emerged.
RECENT DEVELOPMENTS
AND CONSEQUENCES
6. Further local upheaval has been brought
about by the amalgamation of Primary Care Trusts (13 down to five
in Essex), the "scrambling" of Forum Support Organizations,
and now the fore-shadowed abolition of Forums with the formation
of LINks (with an elongating time scale now likely to extend to
2008). We have already seen significant "haemorrhage"
of experienced Forum members, who, in spite of official protestations,
feel undervalued and stifled. This means the loss of useful personal
and local knowledge built up by the dedication of Forum members.
This "haemorrhage" is likely to become
a flood if confidence is not restored.
SUMMARY AND
RECOMMENDATIONS
7. The West Essex PPI Forum, together with
that of our local acute Trust (Princess Alexandra Hospital), believes
that the best way to achieve the increased representation expected
of LINks would be to retain the presently reduced number of Forums
as the nucleus of LINks, with their statutory powers intact, but
with revision of the terms of reference to remove the overlap
of activity.
8. The locality focus of the existing Forums
has made a real difference to health care. We do not see a problem
with the creation of Foundation Trusts as we believe there is
a need for patient and public involvement from the Purchaser/Commissioning
aspect to have "arms length"" inspection and monitoring
powers linked with those of the Governing Body
9. We understand that the Government has
already indicated a willingness to consider the retention of monitoring
and inspection rights, but only for a core group, properly vetted
and trained. We would suggest that this could most easily be achieved
by retaining the existing Forum structure as a basis. This would
go a long way to alleviate concerns about the loss of vitally
important "local input" into health care planning and
provision.
10. We hope that the Select Committee will
give this serious consideration before the legislation is "set
in stone", and that the members appreciate that an early
pronouncement could bolster morale amongst the voluntary supporters
of the health service, morale which presently is ebbing steadily.
West Essex PPI Forum
January 2007
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