Agenda item

The Health Partnerships Overview and Scrutiny Committee will be aware that the government has published its white paper on the future of the NHS, Equity and Excellence – Liberating the NHS.  The white paper outlines a radical set of proposals for change within the NHS. The council has prepared a response to the white paper, which is included as an appendix to this report. The Health Partnerships Overview and Scrutiny Committee will be given an overview of the main proposals in the white paper and the council’s response to them. Officers from NHS Brent will also be able to offer their perspective on the white paper to the committee.

Andrew Davies (Policy and Performance Officer, Policy and Regeneration) opened discussion of this item by explaining that the Government White Paper, “Equity and Excellence: Liberating the NHS” had been published in July 2010, and that consultation on it had closed at the end of the previous week. He explained that the Council’s response had been sent to the Department of Health, in the form of a letter from the Lead Member for Adults, Health and Social Care.

Andrew Davies summarised the Council’s response as follows: that the Council had serious concerns about giving untested GP consortia responsibility for spending £80bn of public money at a time when considerable cuts are being made to public spending; that the Council wanted an enhanced role in service commissioning; that the Council wanted an enhanced role in service commissioning; that the Council supported the establishment of health and wellbeing boards, although it had concerns about scrutiny powers being transferred to them; and that the Council welcomed having a greater role in public health which it could co-ordinate through its current activities.

Mansukh Raichura (Chair, Brent Local Involvement Network) noted that the White Paper envisaged the transferral of some responsibilities to local authorities, but he expressed concern that this would be without additional resources or without local consultation. Additionally, with GPs being providers and commissioners under the terms of a national GP contract, there would be limited or no local input into the way commissioning would be carried out. Mark Easton (Chief Executive, NHS Brent and Harrow) replied that the White Paper was ambiguous, as the new public health responsibilities of local authorities had not been clearly defined and it was not clear what funding would be given to local authorities to carry out these functions. Councillor John (Stonebridge ward) commented that public health had for many years been a difficult area to define, as Council functions and health service functions overlapped in some areas. She welcomed the fact that the Council would be given greater responsibilities in this area, and that this would increase the opportunities for the Council to co-operate with other bodies.

Councillor Kabir noted that it was not clear how health and wellbeing bodies would be constituted and would function, adding that it was important for the Council to do its best to ensure that the Brent health and wellbeing board would have the needs of Brent residents at a priority. The Vice-Chair expressed concern that the health and wellbeing board could see a conflict of interest between its executive and scrutiny functions and that the Council’s role in scrutiny would remain vital.

Residents expressed concern with various aspects of the proposals, such as the role of GP consortiums in commissioning; and the fact that commissioning would be performed on a national basis, without a body to scrutinise it nationally.

Councillor Ruth Moher (Lead Member for Adults, Health and Social Care) then thanked Andrew Davies for the clarity which his report had brought to some of the arguments.

RESOLVED:

that the Committee endorse the Council’s response to the White Paper, “Equity and Excellence: Liberating the NHS.”