Lansley must do better on accountability
Posted: 30 January, 2011 by Andrew Craig
Mr Lansley is a convinced man. But that’s not good if it means his mind is closed. His understanding of accountability in the new NHS he is proposing is precarious, judging by what he said to Andrew Marr in an interview today. Despite what is in the Bill, he said nothing about how commissioning consortia will be accountable to service users and their local public other than for achieving clinical outcomes and enabling patient choice. That’s important but it doesn’t equal “accountability” in MAC’s book.
A meagre meal with only councillors at the table
Judging by the Andrew Marr interview, Mr Lansley thinks everything to do with local accountability can be routed through the Health and Well Being Boards (HWBB) because Councils have elected members and that confers sufficient democratic legitimacy. We do not agree. There must be independent lay people able to challenge on these boards.
His statement that HWBBs will be “publicly open and publicly accountable bodies, so accountability will be enhanced” is very welcome, but it may come as a surprise to some Councils setting them up behind closed doors.
If accountability comes down to “put a few councillors around the table and let Local Healthwatch have a seat”, then it’s going to be a pretty meagre meal. We’ve asked Whose NHS Is It Anyway? Lansley isn’t giving a sufficient answer. Does he understand the question?
Independent health scrutiny retained
This week the Centre for Public Scrutiny pointed out that pace what was proposed in the White Paper, in its response Government confirmed that councils would retain a separate health scrutiny function over and above what the HWBBs do.
That is important because HWBBs cannot scrutinise themselves. It will be interesting to see what role independent health scrutiny plays when – to take a hypothetical situation – patients and citizens complain to the Council that, despite what the new Bill says, they aren’t being involved in the local consortia’s decision making.
And what will the National Commissioining Board (NCB) make of Mr Lansley’s view, seeing as the Bill makes it clear that they are required to “promote the involvement of patients and their carers in decisions about the provision of health services to them.” “Section 242” duties are not going to go away.
BMA endorses patient participation groups
The 2nd reading on Monday and the committee stage will be pretty lively I suspect. Meanwhile, the BMA has endorsed patient participation groups as advantageous for practices and patients in its briefing in advance of tomorrow’s 2nd reading of the HSC Bill (scheduled for 2.30pm).
Clearly they see PPGs and Local Health Watch (LHW) as complementary not interchangeable (as some other commentators are tending to do), with both being needed for comprehensive engagement. This is a positive development.
A nudge from North Liverpool
We’re told North Liverpool consortium is insisting that each constituent practice has a patient participation group. Will this set a ball rolling? If this is what “nudge” is about, we are all for it.
The Moore Adamson Craig Partnership supports user and public participation, trains lay representatives and develops responsive health, care and education organisations. We are ready to work with and support all those who want to make sense and a success of the new structures of patient and public engagement within the new arrangements for health and social care commissioning and providing. Feel free to contact us to discuss the opportunities.
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