from the official Healthwatch was a letter urging them not to choose a similar name, for fear of confusing people. The reply was that there could be no confusion, because no members of the public would ever have heard of the official Healthwatch!
The People’s Inquiry concluded that Healthwatch in its current form is unlikely to deliver an effective voice for local communities, and recommended that they be wound up, with new bodies established that should be separated from the CQC and modelled on the old CHCs.
They should link up with local community organisations, pensioners groups and other community organisations, and be given the statutory powers to inspect hospital and community services, to object to changes which lack public acceptance, and to force a decision on contested changes from the Secretary of State.
The invisibility and impotence of Healthwatch is rivalled by many of the Health & Wellbeing Boards (HWBs), which were also established under the HSC Act. However HWBs are not NHS bodies, but controlled locally by councils with social service responsibilities. The unusual flexibility of the phrasing of the Act gives council extensive discretion on how public and outward-going the HWBs should be. There is the possibility to make them campaigning platforms, or a way to hold local health managers to account. But so far not one council has taken the chance to co-opt campaigners, community leaders and advocates of patient groups, and create HWBs as a vibrant, proactive public forum for scrutiny of local NHS commissioners or providers.
The London People’s inquiry again recommended a substantial change, calling on councils to ‘make underachieving and narrow Health & Wellbeing Boards into genuine platforms for the planning and scrutiny of public health, health and social care in each borough’. It suggested that one way forward might even be to merge HWBs with Healthwatch,
to create a single, clear and authoritative, democratic voice for local people that will monitor and scrutinise local health and social care services and plans for future developments, but also champion patient complaints.
Of course, one other important player behind the scenes of CCGs, in addition to the control exercised by NHS England, is the shadowy network of ‘commissioning support units’, some of which are clearly steering the CCGs towards greater and wider moves to put services out to tender. These bodies too are beyond any public scrutiny or accountability, and it seems likely that many of them would be privatised if the Tories win the next election: they are all due to be put out to tender by 2016.
7
Myth: Our NHS reforms will make the NHS more transparent and accountable.
The NHS will become more transparent under proposals set out by the Health Secretary.
1
Press release from Department of Health and Andrew Lansley, October 2011
There was plenty of rhetoric about accountability and transparency in the period during the passage of the Health and Social Care Bill but an examination of the small print revealed that the reality would be different. There was an early indication of Lansley’s real attitude to transparency when he refused to publish the risk register (which looked at the potential dangers if the Bill passed) despite having been ordered to do so by the Information Commissioner.
Clause 1 of the Bill ends the duty of the Secretary of State for health to ‘secure or provide’ a universal and comprehensive health service in England. This was a line in the sand for Lansley who was determined to make this change. The HSC Act has resulted in confused lines of accountability and a situation where a Secretary of State for health can criticise the NHS without offering solutions or acknowledging responsibility for problems arising from government policy.
Many features of the HSC Act conspire against transparency in the NHS. New bodies created by the Act do not have tomeet in public or publish their minutes. There are
The People’s Inquiry concluded that Healthwatch in its current form is unlikely to deliver an effective voice for local communities, and recommended that they be wound up, with new bodies established that should be separated from the CQC and modelled on the old CHCs.
They should link up with local community organisations, pensioners groups and other community organisations, and be given the statutory powers to inspect hospital and community services, to object to changes which lack public acceptance, and to force a decision on contested changes from the Secretary of State.
The invisibility and impotence of Healthwatch is rivalled by many of the Health & Wellbeing Boards (HWBs), which were also established under the HSC Act. However HWBs are not NHS bodies, but controlled locally by councils with social service responsibilities. The unusual flexibility of the phrasing of the Act gives council extensive discretion on how public and outward-going the HWBs should be. There is the possibility to make them campaigning platforms, or a way to hold local health managers to account. But so far not one council has taken the chance to co-opt campaigners, community leaders and advocates of patient groups, and create HWBs as a vibrant, proactive public forum for scrutiny of local NHS commissioners or providers.
The London People’s inquiry again recommended a substantial change, calling on councils to ‘make underachieving and narrow Health & Wellbeing Boards into genuine platforms for the planning and scrutiny of public health, health and social care in each borough’. It suggested that one way forward might even be to merge HWBs with Healthwatch,
to create a single, clear and authoritative, democratic voice for local people that will monitor and scrutinise local health and social care services and plans for future developments, but also champion patient complaints.
Of course, one other important player behind the scenes of CCGs, in addition to the control exercised by NHS England, is the shadowy network of ‘commissioning support units’, some of which are clearly steering the CCGs towards greater and wider moves to put services out to tender. These bodies too are beyond any public scrutiny or accountability, and it seems likely that many of them would be privatised if the Tories win the next election: they are all due to be put out to tender by 2016.
7
Myth: Our NHS reforms will make the NHS more transparent and accountable.
The NHS will become more transparent under proposals set out by the Health Secretary.
1
Press release from Department of Health and Andrew Lansley, October 2011
There was plenty of rhetoric about accountability and transparency in the period during the passage of the Health and Social Care Bill but an examination of the small print revealed that the reality would be different. There was an early indication of Lansley’s real attitude to transparency when he refused to publish the risk register (which looked at the potential dangers if the Bill passed) despite having been ordered to do so by the Information Commissioner.
Clause 1 of the Bill ends the duty of the Secretary of State for health to ‘secure or provide’ a universal and comprehensive health service in England. This was a line in the sand for Lansley who was determined to make this change. The HSC Act has resulted in confused lines of accountability and a situation where a Secretary of State for health can criticise the NHS without offering solutions or acknowledging responsibility for problems arising from government policy.
Many features of the HSC Act conspire against transparency in the NHS. New bodies created by the Act do not have tomeet in public or publish their minutes. There are
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