1. At the evidence session on Thursday 8
February, my Chair, Sharon Grant, gave evidence and alerted the
Enquiry to the rationale put forward by the Department of Health
for the abolition of the Commission and her concern about the
lack of a Race Equality Statement to underpin the LINk proposal.
The purpose of this letter is to add further clarification on
these fundamental issues as they will have a direct impact upon
the LINk proposals that you are closely examining.
2. Regarding the abolition of the Commission
the rationale put forward and again emphasised by the Minister
in a response to a PQ response on the 15 January:
3. At the time of the announcement of the
abolition of CPPIH in 2004 the budget was £33 million, in
2006-07 it is £28 million, reducing the amount to the "frontline"
by £5 million. The Commission has estimated that the true
central cost of CPPIH is currently approximately £1.5 million
which needs to be viewed against the "central costs"
LINks will occur:
4. From the list above, (which is not meant
to be exhaustive), it would appear that the replacement system
will create more local bureaucracy and may actually reduce the
"... funds to the frontline". The Commission's spend
on its central support functions—the "bureaucracy"
is below the average spend of other ALBs and it sets the governance,
strategic direction and operational deliveries of the national
organisation. Attached to this letter is a description of the
role of CPPIH. (See Annex A)
6. The review in question commenced 18 months
after the abolition of the Commission was announced and it is
only now, in the setting up of Early Adopter sites, to examine
whether LINKs will actually work is evidence being gathered and
evaluated to see if the proposals will really work. Again, policy
and legislation is not being built upon from a firm evidence base
and Parliamentarians find themselves in a position to need to
legislate.
7. As you are aware, one of the key objectives
of patient and public involvement is to address inequalities in
health, by engaging those who are most affected by them in decision
making. In fact, CPPIH has a specific remit to target the harder
to reach groups of our society and help them to engage and give
them a voice in the decision making process. It is of concern
to CPPIH that in planning the new system the race dimension of
health inequality is properly taken into account, and that the
system in future is built in such a way as to maximise engagement
of all sections of the community. Indeed the DH has a statutory
obligation to consider the race and disability implication of
any major policy change.
8. As such we felt it important to know
whether the DH had produced a "race equality statement"
to underpin the new proposals. For information I am attaching
correspondence that was sent to DH on 5 September 2006. To date
no reply has been received to this letter. A follow up letter
was sent last week and if a response is received we will send
a copy to you.[1]
I think the question about what the CPPIH does
is more than just a central question. Some of our activities actually
take place on an area or regional basis but are effectively managed
centrally. Specifically they do not arise from independent local
activities be it of Forums or (in future) LINks. These activities
support the following areas which are detailed in our annual report.
CPPIH:
The following table attempts to show the areas
in which CPPIH provides service, there are three categories:
These are examined in terms of the added value
from each activity, the local alternative might be and potential
issues arising. These are classified as follows:
| Category | Activity
| Description | Value added
| Local alternative | Potential issue
|
| Operations | Best practice |
Identification of best practice in conjunction with Forums and dissemination to Forums
| Bringing together of knowledge across the network and making it available to all
| Co-operation required between multiple organisations
| No overall drive to deliver |
| Operations | Communication to forums
| Providing forums with regular updates about information of interest and a mechanism for dissemination of best practice and other forum activities
| Assists forum volunteers to see themselves as part of a wider network.
Efficiency compared to a large number of local communication activities
| Duplicated communication activity | Efficiency
|
| Operations | FSO funding (Finance)
| Management of the monies paid out to FSOs as part of their contract
| Good financial governance | Local financial management needed
| Efficiency |
| Operations | FSO performance management
| Management of contract compliance | Ensures value for money from contracted services
| Local performance management needed | Efficiency
|
| Operations | FSO procurement |
Procurement of support services | Consistency of procured services
| Local procurement services needed | Efficiency
|
| Operations | Help desk | Phone and email contact point for forum members, other organisations and public
| Consolidated service provides operational efficiency personal response always available in working hours
| More resources available locally or reduced availability
| Efficiency |
| Operations | Learning and development
| Provide learning and development opportunities to support induction of new members and ongoing development opportunities
| Consistency of training.
Efficiency as not a full time task for every forum.
| Duplicated L&D activity or requirement to purchase training from external organisations if available.
| Efficiency |
| Operations | National activities
| Co-ordination of activities in which large numbers of Forums are involved eg Bugwatch, Fairtalk, Food watch.
| Clear mechanisms for forums to work together.
Opportunity to raise national profile of national issues identified by forums.
| Co-operation required between multiple organisations
| No overall drive to deliver |
| Operations | National reporting
| Analysis of forum activity for reporting to Ministers, parliament and stakeholders
| Synthesis of many individual inputs | None
| Not available |
| Operations | Networking Events
| Bringing together forums within and across regions to share ideas and develop best practice
| Improved transfer of information | Co-operation required between multiple organisations
| No overall drive to deliver |
| Operations | Networking systems
| On-line systems to enable forums to:
— share information with each other;
— meet FoI requirements and be seen to operate openly
| Single point of reference.
Efficient management and support processes
| Multiple on-line systems | Efficiency
|
| Operations | Parliamentary |
Provision of information to MPs and Peers as requested
| National picture and viewpoint available |
Only local picture and viewpoint available | Not available
|
| Operations | Recruitment |
Generating interest in and recruiting to forums |
National consistency | Locally focussed recruitment
| Consistency |
| Operations | Recruitment—CRB checks
| Processing information to Criminal Records Bureau. Dealing with sensitive check failures
| Assisting forum members to complete forms.Efficiency—expertise is required and small number of resources can handle national requirement
| Local CRB processing required | Efficiency
|
| Operations | Stakeholder relationships
| Single point of contact for national and regional stakeholders needing relationships or communication with Forums
| Efficiency of contact for other organisations
| Multiple points of contact | Not available
|
| Governance | Code of conduct |
Provision and dissemination of code of conduct for forum members and mechanism for dealing with issues arising
| Consistency | Local code of conduct process operate
| Consistency |
| Governance | PPI advice | Interpretation to Forums of legislation pertaining to them. Includes legislation that affects public bodies eg DPA, FoI
| Reference point for forums. Good governance in line with legislative requirements
| Local interpretation | Consistency
|
| CPPIH management | Facilities
| Provision and management of Facilities for CPPIH staff
| Good governance. | No equivalent required
| None |
| CPPIH Management | Finance (CPPIH)
| Management of internal CPPIH Finances | Good governance. Value for money.
| No equivalent required | None
|
| CPPIH Management | HR | Management and support of CPPIH directly employed staff
| Good governance. | No equivalent required
| None |
| CPPIH Management | IT (CPPIH)
| Provision and management of IT services for CPPIH staff
| Good governance | No equivalent required
| None |
| CPPIH Management | Planning |
Overall management of CPPIH and contracted resources
| Good Governance | No equivalent required
| None |
