Further supplementary evidence from the
Commission for Patient and Public Involvement in Health (PPI 109D)
I have listened to the evidence given by the
Minister of State, Rosie Winterton, at your Inquiry on Thursday
1 March, and feel it is necessary to formally draw you and your
Committee's attention to a statement the Minister repeatedly made.
In giving her evidence the Minister asserted
that by abolishing the Commission £9 million would be available
to the "front line".
The Commission currently provides services to
Forums (the "front line") through directly employed
staff and through contracts with Forum Support Organisations (FSOs).
While the majority of services are provided locally through FSOs,
it is sometimes more efficient or more consistent to provide services
directly from the CPPIH especially when the capacity for local
support is still developing. If FSOs (or future organisations
supporting LINks) were to provide these services instead of the
CPPIH we believe the costs would increase, or the service levels
would decrease for the same budget. Clearly contracted organisations
are not going to do more work for the same or less money.
The Minister's assertion that the CPPIH somehow
spends £9 million pounds on "bureaucracy" is inaccurate
and fails to recognise the amount of direct support to the "front
line" that the CPPIH provides in a highly cost effective
manner.
The Commission has estimated that the true central
cost of CPPIH is currently approximately £1.5 million and
this is the total of "new money" available to the front
line and, as such, this is the true cost of reducing ALB bureaucracy.
This £1.5 million provides the national infrastructure of
CPPIH and needs to be viewed against the "central costs"
LINks will occur:
— Local Authority procurement costs
for LINks contracts x 152.
— Any Local Authority accommodation
and IT charges being applied to the budget award.
— Start up capital for desktop IT etc
x 152 LINks.
— Redundancy costs of CPPIH staff.
— Landlord costs for early surrender
of CPPIH office leases.
— Costs of induction training for LINks
members and host organisation personnel.
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.
In our evidence the Commission estimated that
it would cost over £60 million to have LINks run successfully
and the assertion that this is an overestimate is not borne out
by the Commissions experience. For example, the Minister spoke
about a LINk event in Durham that was to be held later that week
and that this was not costing a great deal of money to organise.
She was obviously unaware that there were three deaf people attending,
each with their own specialist help, and this is costing £1,200
in addition to the cost of the venue. While this is still a relatively
small amount it needs to be considered in the context that there
will be hundreds or thousands of such events taking place throughout
the country.
I have kept this letter deliberately factual
and refrained from drawing conclusions. However, given the experience
of the Commission the budget that Local Authorities will receive
will be inadequate and will therefore provide a limited service.
This will not satisfy the local population and it will be left
to Local Authorities and Parliamentarians to pick up the pieces.
Dr. Steve Lowden
Chief Executive, Commission for Patient and Public
Involvement in Health
6 March 2007
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