Written evidence from Mary E Hoult (CFI
05)
I am submitting this from a carer perspective. The
Personalisation Agenda for social care has put the control over
commissioning care with the service users themselves in order
to put the patient at the heart of everything, Health & Care
through the eyes of the patient.
Following on from my previous papers on the subject
of Commissioning.
Working from paragraph 118 page 36 in the Committee's
Third Report:
The committee regards the principle that there should
be greater accountability by commissioners for their commission
decisions. To highlight the importance of this principle, I wish
to show a recent example of how decisions were made that resulted
in the following headlines:
Shock Decision by Leeds City Council—CohearentVision
left out in the cold as Birmingham based organisation awarded
"Leeds Deaf Services" contract, and "Action for
Blind People" lead successful consortium bid to provide "Leeds
Blind Services", value £1 million.
The previous contract was held by CohearentVision
better known as the Leeds Society for the Deaf & Blind who
claim to have provided a high level service with reducing contract
costs by over £200,000 per annum over a three years period.
They also offered to deliver the new contract on a service specification
for 26% less but failed in the tender process.
Currently the new contract starts 1 April 2011 and
it is yet unclear what the handover process to ensure a smooth
transition will be.
Charities bidding against each other seems to the
lay person a sad state of affairs. Awarding Leeds services to
Birmingham control, is contradiction to the concept of localism.
How does this help "The Big Society"? This seems to
have been overlooked in this instance, leaving only accountability.
How all this will pan out does leave patient/service users very
worried indeed.
In my years of attending NHS meetings I have been
struck by many examples of how accountability can be a moveable
feast. Two examples come quickly to mind:
— although
meetings are held in public, the practice of having certain agenda
items in private session continues and even increases. Surely
decisions which inevitably impact on public expenditure should
at least be heard in public?
— Questions
I raise, as a result of meetings attended, often go unanswered
despite lukewarm promises. This can apply to both written and
verbal requests. The impression is that engaging with the public
is not a priority more an inconvenience. Where is the spirit of
openness and accountability?
Whatever changes your Committee recommends, we need
to be sure that structures, reporting arrangements etc. fully
support accountability and good governance. In the past, whatever
the architecture, health bodies have had a tendency to function
as much for their own benefit, as for the purpose for which they
were created. The role of the non executive is key to this. Legitimate
challenge should be welcomed and encouraged. Only then can the
public begin to believe that the patient is at the heart of the
NHS.
Can the Select Committee look into the governance
of all and how this contract links into the Health and Social
care agenda to provide clarity and accountability for service
users who are still in the dark about these changes?
January 2011
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