Health and Social Care (Re-committed) Bill

Memorandum submitted by Devon County Council on behalf of the Strategic Director People (HSR 29)

1. Devon County Council wholeheartedly welcomes the Government’s amendments to the Health and Social Care Bill in relation to:

o The role of health and wellbeing boards in the joint commissioning of health and social care services;

o User and patient involvement in decision-making;

o Enhancing the local democratic legitimacy of health services and;

o Co-terminosity between local authorities and clinical commissioning groups

2. The Council wishes to draw the following three areas to the Committee’s attention:

2.1 Clinical networks and senates - there are more checks and balances in the modified Bill than there were in the original Bill, particularly in relation to the functions of the health and wellbeing boards (HWB). The Council understands that clinical networks and senates will work at the regional and sub-regional levels to look at health and social care pathways. The input of social care, local government and public health at those levels will be important. However, the role that clinical senates and clinical networks might have in relation to HWB and clinical commissioning consortia at local level needs to be clearer.

2.2 Integration of health and wellbeing – whilst the Bill promotes the integration of health and social care, the Council is concerned that it does not necessarily integrate health and wellbeing. This is the case in relation to the responsibilities of clinical commissioning groups for emergency care where there must be integration with local authorities’ functions for safeguarding, mental health services and services for homeless people.

2.3 Public health - the proposed responsibilities, accountabilities and relationships for public health between the national and local levels are not yet clear. It is unfortunate that the timescale for the passage of the Health and Social Care Bill is not aligned with the Government’s response to the Public Health White Paper. Whilst the amendments to the Bill do not touch on provisions in relation to public health, it is vital that any legislative implications of the transfer of responsibilities for health protection and health improvement to local authorities are considered as part of the current process.

July 2011

Prepared 11th July 2011