Health and Social Care Bill

Memorandum submitted by the London Scrutiny Officer Network  (HS 14)

Introduction

The London Scrutiny Officer Network is an informal network of officers supporting scrutiny members. By our calculation there are approximately 1,861 councillors in London . Of this number approximately 1,500 are non-executive councillors and many of this group will have experienced taking part in overview and scrutiny and in scrutiny of health and social care. It is in our wealth of collective support to this large number of elected councillors on the ground that we draw upon in raising comments on the Health and Social Care Bill.

The Officer Network has been meeting for the past ten years and its role is in brief to:

·   Share best practice and exchange ideas;

· Help build capacity of scrutiny officers and members through learning and development activity;

· Provide practitioner-to-practitioner, peer support;

· Work with and support members in promoting and championing scrutiny across London and nationally.

As practitioners, officers of the Network represent the variety of scrutiny support arrangements across local government. The officer support ranges from dedicated scrutiny officers (and health scrutiny officers), to officers who support both policy and scrutiny or democratic services and scrutiny, across a range of salary grades (assistant chief officer to more junior positions). The experience of supporting scrutiny members ranges from 11 years to recent appointments as well as those who have helped to build the architecture and culture of health scrutiny and contributed to the development of successful scrutiny in their boroughs.

We would like the Committee to note that the views expressed in this submission are those of individual scrutiny officers working in London , based on their experience and not of their councils or their members.

In supporting cross party councillors to carry out their formal health scrutiny roles,  many scrutiny officers have witnessed first hand the powerful influencing role that independent and objective critical friend challenge can bring to the discussions on complex health and social care changes within the borough and beyond the council’s geographical boundaries,

·   By enabling plans on services and spend to be changed by health decision makers;

· Ensuring a focus on addressing inequalities and outcomes;

· Creating space for patients and public voice to be heard and using experiences to build evidence to inform commissioning decisions;

· Placing emphasis on equal access to health services;

· creating a neutral political space for a range of interested people (professionals, residents, community organisations , providers and decision makers for example) to discuss complex service configuration  within and beyond borough boundaries;

· Bringing a whole systems approach to discussion and debate.

The key points we wish to make in our submission are as follows:

  1. Scrutiny role and GP Commissioning Consortia

It is unclear in the Bill whether overview and scrutin y can hold GP Commissioning Consortia to account.  To simplify and make clear the accountability framework, and drawing upon the current arrangements which work well, we would argue that overview and scrutiny should have the power to hold GP Commissioning Consortia to account.

This clarity on the role of overview and scrutiny should be extended to make the wording clear in the Bill that all commissioners and providers of health and social care services are subject to scrutiny by local authorities overview and scrutiny function. We assume that the Centre for Public Scrutiny will be providing comment on the specific areas of the Bill.

  2. Foundation Trusts

We had hoped to see the Bill address the current accountability gap that exists with Foundation Trusts (FTs). To empower patients and public alike and to enable scrutiny of spend and key decisions we would suggest that there should be a formal holding to account of FTs by scrutiny members. We also believe that FTs should hold regular meetings in public and publish minutes of their meetings.

 3. Health Overview and Scrutiny Committee power of referral to the Secretary of State

We consider that the proposal to shift the current referral powers from the health overview and scrutiny committee to full council is a significant weakening of accountability and may well make referrals highly party political.

The current arrangements ensure that due to the cross party nature of scrutiny that where referrals have occurred they are objective and evidence based.  Our experience has shown that scrutiny member use their powers responsibly. We would argue that the referral power is retained by the health and overview scrutiny committee.

4. Health and Wellbeing Boards

We are not sure that p ublic accountability gap on health and well being boards will be addressed by the membership suggested in the Bill. Due to the focus and attention of the Boards we would suggest that they should be requ i red to meet in public.

5. HealthW atch

Based on our collective experience of working with and supporting LINKs (and PPIFs prior to LINKS), we believe that HealthW atch will not be able to carry out the aims and ambitions set out in the Bill without proper and realistic resources.

    Conclusion

In conclusion we hope that you are able to consider our comments and suggestions as part of your deliberations on the Health and Social Care Bil l.

 February 2011