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Exclusive: flagship HealthWatch policy to be 'watered down' by amendments

Government plans to amend the Health Bill to clarify arrangements for HealthWatch have angered campaigners who claim the change will “water down” patient and public involvement in the NHS.

Under the existing wording of the bill, local HealthWatch branches will be statutory organisations charged with scrutinising health and social care services in the area when they replace local involvement networks in April 2013.

However, HSJ understands the government is to table amendments before parliament next week which if passed will remove the statutory status of the organisation. Local authorities, which will commission local HealthWatch, will still have a responsibility to ensure duties around scrutiny and providing advice to the public are carried out.

The National Association of LINks Members claims the removal of statutory status will undermine the influence of Local HealthWatch with commissioners and providers. They also fear it will reduce the opportunity for lay involvement in running the organisation.

In a letter to association chair Malcolm Alexander, health minister Earl Howe said it was never the government’s “intention” to legislate for a single organisational model for local HealthWatch.

He says he is “unconvinced” creating 152 statutory corporate bodies is the solution to NALM’s concerns and local HealthWatch organisations should be set up following extensive public consultation in order to have democratic legitimacy.

Mr Alexander told HSJ removing statutory status amounted to a “watering down” of the policy.

The last patient and public involvement organisation to have statutory status were community health councils which are widely regarded as having been more effective than the patient and public involvement forums and then LINks which replaced them.

Future Forum member and senior research fellow in patient and public involvement Sally Brearley told HSJ it was “extremely” disappointing that local HealthWatch would not have statutory status.

“We think it would have given it teeth and a clear role. I don’t think ministers have appreciated the implications of what’s now being proposed which is potentially the loss of lay voice and the lay role in monitoring services.”

However, Tim Gilling, deputy executive director of the Centre for Public Scrutiny, told HSJ flexibility over how the organisations were set up was welcome as long as “their activities remain rooted in statute”.

A Department of Health spokesman said the amendments “aim to make clear our intention regarding HealthWatch”.

He described it as “nonsense” that the change was a “watering down” of the policy and said without statutory status local authorities would have greater freedom and flexibility to shape the organisation.

Readers' comments (9)

  • I don’t think ministers have appreciated the implications of what’s now being proposed which is potentially the loss... of the health service as we know it.

    He says he is “unconvinced” creating 152 statutory corporate bodies is the solution - shame this isnt about CCGs...

    Personally, I'm pleased. Duplicitous bastards.

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  • My local Health Watch have been crowing about their soon to be statutory status - that's the healthwatch made up from the current links group - who see themselves transferring straight across from one group to the other. Telling us all about thier new "teeth", what they will achieve and exercising their new found power. It's a shame, becuause, it may have made a difference in the long term, giving healthwatch an indpenednt role - as opposed to an arms length quango of the ever powerful local authority. But, hey, Pickles, Lansley and Cameron (or plc as I prefer to call them), have to give these Councillors something to meddle in and do, now they're flooating off their social services departments into social enterprise company's.

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  • Interesting. If I remember "Equity & Excellence" correctly, it talked about putting HealthWatch out to tender. If Local HW was a string of statutory bodies, this would preclude a pure for-profit or social enterprise business model. Removing this requirement will allow AQP to play - Patient Involvement PLC anyone?

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  • Ah the great circle of NHS change .... many many moons ago as a CHC Chief Officer - and Community Health Councils were statutory bodies - I can recall the reality of this. CHCs that ran professionally, developed their members, worked with patients and the public, represented credible challenges and built constructive relationships could nearly always achieve improvements. Being a statutory body gave you practically no leverage as such. But we now seem to have reached the point that the only supporters of the bill are political supporters like the Cameron groupies who wrote to the Telegraph yesterday ... Everyone else has lost confidence in the bill, in what is now an incredible example of how to show that you can alienate all of the stakeholders, all of the time ...

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  • In practical terms, how will it make ANY difference if LHW is a 'statutory body' or not? I can't think of a single example where this will make the slightest bit of difference. Can anyone explain?

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  • anon 12.26
    Well, I'm speaking as a Chief Officer of a Community Health Council in Wales (yes, we still have them here, and there's pretty solid support). So what benefits does statutory status give us ?
    - our role is clearly and legally defined; everone knows that we're set up to do, where we get our members from and who we're speaking on behalf of
    - when it comes to discussions around service change and (sometimes) closures, we're the clearly identified body who engage with the public and aim to provide the broad public view. Health Boards have a statutory responsibility to consult with us, and if we can't support proposals, we have a statitory right to take our concerns to the Welsh Health Minister
    - we also have a statutory right to visit and inspect all NHS premises in our patch (unannounced if we feel its appropriate) and see comments and action from Health Boards on our findings
    - we've got a statutory role in supporting patients (if they desire) with complaints on NHS services

    That's just a summary. But above all, what the statutory status gives is authority and clarity. Everyone knows what our role, position and responsibility is, and where we draw our auhtority from. Its laid out in law. It also helps to maintain our independence and ability to speak for patient and communities. Yes, sometimes we could do it better, but our role is clearly understood..

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  • Paul Tovey

    The red+blue herring of the CHC's shoals and trying to catch some again so they can be made to swim in our times with more than middle class fins on them, is not a good trawling point here. I have my radar on while snorkelling HSJ.

    It's part of NALM being "Top-Down" frankly because Malcolm does want the return of the CHC's shape slid fishily into the bill .

    Straightforward powers to view in on local Service Level Agreements (checking the ideal against the patient experience reality ) is not going to end, and is not rocket science to teach. Enter and Viewing wards and units/care homes does require some filters and knowledge, but its not going to end as a means of scrutiny.

    Protecting peoples rights to consultations is enshrined in NHS law (2006 Act) though is weaker in Social Care, in the 2007 Act which "empowers" LINks. Anyone can read it all and act on it to protect those rights as much as possible . Anyone can do that and see these rights will not end with Lansley's Bill

    NALM is full of good people but really should have concentrated on producing a DIY manual bottom-up monitoring methodology with examples of concrete practices that empowers all (bottom up) of how to to view in on all services. The part-NALM drip-fed desire promotion of CHC's is noted, but they are not the only structures that can serve public lay scrutiny of Health and Social Care.

    It's a question though whether some more of the LINk ego-players and ego-ritualists will hear the lessons and implement good un-greased monitoring practice regardless of LA's , Councilors , NHS bodies etc . No-one owns you in this democracy or what you do within the law. You use powers and legal rights like the FOIA, and form concerns. You are not recognised for having power unless you can make critical informed views available based on evidence gathered.

    Speaking as an ex monitoring anti-shark in the dodgy NHS shark and barracuda seas I would like people stop getting hung up on bureaucratic structures the London centric left-right crowds wish to dominate with the usual suspects, and go-local and promote findings Online . Being independent means doing it, not talking about it forever waiting for centralised power like I have seen too many people do .

    Local power is generated by actions and hooking into information various NHS bodies try to keep away from the democratic pool.

    Remember you too have a secret anti-shark fin hidden away - for God's sake strap it on and start swimming.

    Yours Jaws

    Paul Barry Cutie Tovey

    Ps : Ignore the image of the dog-icon which now misrepresents me - I am awaiting my new sleeker underwater form...

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  • If you believe in public involvement, then it seems infinitely preferable to have Local Healthwatch as a system of statutory bodies (created by and acting with the authority of Parliament), rather than as the playthings of Local Authorities (who they are supposed to monitor and hold accountable). If it goes in the latter direction, then wave goodbye to any independent representation of the public voice.

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  • If you believe in public involvement, then it seems infinitely preferable to have Local Healthwatch as a system of statutory bodies (created by and acting with the authority of Parliament), rather than as the playthings of Local Authorities (who they are supposed to monitor and hold accountable). If it goes in the latter direction, then wave goodbye to any independent representation of the public voice.

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