It’s quite a trick to condense a monster Bill like the Health and Social Care one into a single sentence, but Mr Lansley managed in the 2nd reading debate this afternoon in the House. He stated the purpose of the Bill as “to improve health of the people of this country and the health of the poorest fastest.” All the reform eggs in one basket so to speak.
He elaborated on this principle, saying
“In this Bill patients will come first: involved in every decision about when, where, by whom and even how they are treated. There must be nothing about me without me. The Wanless Report in 2002 called for patient engagement to happen; it didn’t, now it will.”
PPI duty restated by Government
More prosaically, the Government’s response to the Health Select Committee report commissioning of 18 January published today restates the duty of patient and public involvement in no uncertain terms (paragraph 111)
The Health and Social Care Bill places a duty on consortia to make arrangements to involve individuals to whom services are being or may be provided in planning commissioning arrangements; in developing and considering proposals for changes in the commissioning arrangements where those proposals would have a significant impact on how services are provided or the range of health services available; and in decisions affecting the operation of commissioning arrangements that would likewise have a significant impact.
What we should expect them to deliver
Mr Lansley wound up his speech by listing four characteristics of the new arrangements.
“We will place the individual needs of patients above all else, encouraging wherever possible a personal approach to health care, tailoring services to have the greatest individual and also greatest overall impact.
Decision making in the consulting room, in local service design, in commissioning and in the services any particular provider offers will be local decisions. There will be real autonomy and real devolution of power.
There will be a relentless focus on quality, embedded in a new legal duty.
There will be a diverse and vibrant social market for healthcare. We will encourage NHS staff to set up social enterprises and foundation trusts and will encourage new capacity in delivery of services through social enterprises, charities and private companies and, indeed, NHS providers. Clinicians and their patients together will lead the NHS.”
Patients and the public must have the last word
Mr Lansley makes great play about local democratic legitimacy and accountability. His words today and the words in the Bill say what this has to mean over and above what Health and Well Being Boards might do. Build this new participative world from the bottom up and start with the GP practices.
MAC believes that it is up to local lay activists to inform themselves about this and approach their consortia leaders now to say what they want PPI in the new commissioning arrangements to mean – Don’t wait to be told.
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.