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SOCIAL SERVICES NORTH WEST (NWASSA)
MEETING ON 15 JUNE 2001 AT TAMESIDE
REPORT OF THE CO-ORDINATOR
WORKING WITH THE NATIONAL HEALTH SERVICE
1. Matter for Consideration:
To consider how to respond to proposals from the new Government about the further reform of the National Health Service and related social care services.
- Introduction:
Social Services North West undertook considerable activity in this area of work during the autumn and winter of 2000-01, including a major conference and a second meeting with the Regional Chair of the NHS Executive. In the pre-election period this matter has been somewhat in abeyance whilst other priorities are addressed, but it seems certain that the new Government will proceed with further rapid, and possibly radical, change in the NHS. It will therefore be necessary to consider promptly and carefully the impact of such proposals on the delivery of social care by councils.
3. Information:
3.1 The Health and Social Care Bill has been progressing through Parliament through the Spring: this needed to be brought to a swift conclusion in view of the dissolution of Parliament at the beginning of May. Whilst all the provisions for the abolition of Community Health Councils were withdrawn from the Bill, the new role for local authority overview and scrutiny committees in scrutinising the health service were retained. This provision was supported in both Houses and unchallenged by the Lords amendments. Also retained were the duty of NHS bodies to consult the public and the duty for the Secretary of State to provide for an independent advocacy service. Clearly there will be some confusion to be resolved here, as the legislation provides for new arrangements for public and patient representation without removing CHCs. The LGA has suggested that local authorities will need to start discussion with all local relevant partners, including other local councils, CHCs and health bodies, about what arrangements will work best locally, to ensure that there are effective and efficient mechanisms for scrutinising local health services and for improving the local health economy.3.2 The provisions in the Health and Social Care bill in relation to Care Trusts were amended in a number of respects which are significant to local government. Ministers have confirmed that Care Trusts will be NHS bodies, but local authorities will nominate members for the board. Lord Hunt also confirmed that "Care Trusts will be voluntary partnerships and will simply not go ahead unless the accountability and governance arrangements are right." These would cover:
- the extent to which Care Trust boards will be able to make policy decisions about the delegated local authority services and when they must seek Local Authority consent;
- performance management arrangements to enable the local authority to ensure that the delegated functions are carried out appropriately;
- how the Care Trust will be able to feed into local authority decisions on charging and budget setting in relation to delegated services.
3.3 The Minister also gave explicit assurances that Care Trusts will:
- have dual accountability to the NHS and the local authority
- have the local authority representatives selected by the local authority subject only to a probity check by the independent appointments commission;
- have the number of local authority representatives decided by local agreement;
- be able to draw up their own accountability and governance arrangements within a flexible national framework.
3.4 The LGA is continuing to work with the Department of Health on developing the detailed governance and accountability arrangements for these new bodies. It is also arranging a conference on "The new Government and Health: putting Local Government at the centre of the health agenda", to be held in London on 30 July. Delegates will hear about the new Government's health agenda. Speakers will give concrete examples as to how local authorities can take the lead in local partnerships, tackle health inequalities and include health gain measures in an SRB bid. There will be workshops on partnership between local government and health, tackling health inequalities by developing stress indicators and by developing a new local accountability in the NHS.3.5 Clearly the next few months will be crucial in shaping the future pattern of governance and management in health and social care. It is suggested that Social Services North West needs to maintain its top level liaison with the Regional Office of the NHS, and there may also be benefits in developing links at regional level with the CHC movement about public and patient representation and scrutiny of the NHS. Members may also wish to ensure that the North West is well represented at the LGA conference on 30 July, and that, depending on the pace of national developments, a further regional event be considered for the autumn.
4. Recommendation:
4.1 That the report be noted.
4.2 That continuing periodic high-level meetings between the Regional Office of the NHS Executive and Social Services North West be maintained.
4.3 That contact be made with the CHC movement at regional level to address issues of public and patient representation and scrutiny of the NHS.4.4 That further consideration be given to how, through Care Trusts and other mechanisms, local authorities and NHS organisations can build on present joint arrangements for the benefit of service users and carers in their local communities.
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