81. Evidence submitted by Peterborough
Primary Care PPI Forum and Peterborough and Stamford Hospitals
PPI Forum (PPI 3)
Members of the Peterborough Primary Care Patient
and Public Involvement Forum (PPIF) and the Peterborough and Stamford
Hospitals PPIF are very concerned that the government is proposing
to replace PPIFs with Local Involvement Networks (LINks). As you
will know this policy change was promulgated in the Department
of Health document "A stronger local voice", and comes
after the very short period of existence enjoyed by PPIFs. We
have already responded to the DOH document.
We firmly believe that the proposals for LINks
reduce the effectiveness of any Public and Patient involvement
when compared with their predecessor organisations (PPIFs).
We list below the differences that we perceive
between PPIFs and LINks.
A PPIF has statutory responsibilities which
include:
— monitoring and reviewing the
services provided by the trust;
— canvassing the views of patients,
users and carers about these services; and
— preparing reports and recommendations
to the trust about those services, based on the views of patients
and the public.
A PPIF has statutory powers which include...
— the power to collect information
relevant to its functions from particular NHS organisations and
other authorities and to require such organisations to respond
within 20 working days; and
— the power to enter an inspect
premises owned or controlled by the PCT.
The proposed LINks appear from the consultation
document to have no statutory powers or responsibilities. We firmly
believe that without statutory powers or responsibilities the
LINks will not be effective and could be considered as "toothless".
Agenda
— Forums set their own agenda
and devise their own work plans and priorities without political
or commercial interference; and
— LINks will have an agenda which,
as proposed, appears to be susceptible to the influence of politicised
or special interest groups.
The independence of an agenda is essential if
the organisation is not to be perceived as following directions
imposed by powerful lobbyists or special interest groups to the
detriment of representing the patient base impartially.
Funding
— PPIFs were funded independently
of local authorities or the local NHS.
— LINks will rely on the local
authority to pass on funding.
Where funding is controlled by a body which
may be influenced by local politicians there is a danger that
funding might be delayed or curtailed if the funded body raises
politically embarrassing issues. If local funding is unavoidable
then it must be clearly and irrevocably `ring fenced'.
Volunteers
— PPIFs have generally been able
to attract members because they offer the potential to "make
a difference". The PPIFs' roles and structure were clearly
defined and attracted members who have gained knowledge and experience
since joining.
— LINks will attempt to build
a membership drawn from local organisations with specific interests.
By their nature these organisations attract members who have a
specialist interest in a specific aspect of health or social care.
The ill-defined terms of reference and lack of `clout' will make
LINks less attractive to independent volunteers.
Many of our existing members have serious doubts
whether they wish to be part of what could easily become a "talking
shop". They also do not wish to have patient and public involvement
steered by special interest groups, which by their very nature
and purpose were created to represent a specific cause
Monitoring Quality of Service and Standards
— PPIFs had a major role in monitoring
services and processes within the health and care organisations.
This role was clearly a major responsibility of the PPIFs.
— LINks seem to be vague on this
pivotal subject. The key powers of access and response to enquiries
are absent from LINks and it is difficult to envisage how they
can effectively monitor quality and standards without these powers.
Existing forum members see monitoring of quality
standards as a key role. One of the major enablers for effective
monitoring was the statutory framework in which PPIFs worked.
The need to CRB check members who may perform inspections was
given as a reason why this enabler is not present in LINks. It
is possible to have patient and public representative bodies that
embrace both CRB checked individuals and those who decline to
be checked. There is no reason why inspections should not be limited
to those who have been checked.
It is also likely that some voluntary groups
will have CRB checked members. We, therefore, cannot accept the
Government's position that inspection can no longer be allowed.
The Voluntary Sector
— As already stated many voluntary
sector groups represent specific single issue groups of people.
That is why they were founded and that is their legitimate purpose.
It is difficult to envisage that such representation can take
a broad neutral view of health and social care issues in the way
that PPIFs have sought to do.
— There is a presumption within
the document "a stronger local voice" that all the voluntary
sector groups are constituted on the same basis. This is not true.
Whilst large well organised groups eg Age Concern have full time
staff who may be able to devote some time to a LINk many groups
are run on a self help basis by sufferers and their family member
carer. These people work extremely hard at their group and in
providing care to their partners. They also do much unheralded
pastoral work. We question whether such groups could provide effective
membership of a LINk.
— This forum has invested a massive
amount of its time to seeking to make links with the voluntary
sector in this City. This has been met with minimal success.
— We believe that our greatest
success in working with the voluntary sector was in co-opting
advice and information from a voluntary sector group when we undertook
a piece of work relevant to that body's area of interest.
— We suggest that that level of
link up is the right way forward and that widening the representation
on PPIFs as currently constituted will provide the best way forward.
Section 11
— This forum welcomes the strengthening
of section 11 regarding consultation as a progressive and beneficial
reform.
Single Area Body
— The proposal to establish a
single body to oversee one area based upon a social services area
as proposed is a constructive move as for many health patients
the treatment pathway spans both PCT and Acute trust services.
We believe that the PPIF organisation was just
getting into its stride and possibly is now a victim of its own
success, hence the intention to replace it with a `watered down'
version. If we are to avoid this, pressure must be brought to
bear before the proposals are put before parliament.
Peter Edwards
Chairperson,
Peterborough Primary Care PPIF
Annette Beeton
Chairperson
Peterborough and Stamford Hospitals PPIF
11 December 2006
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