Published: 19/08/2004, Volume II4, No. 5919 Page 8 9

Independent health advisers have raised concerns that party political infighting has left some local authority health overview and scrutiny committees 'rudderless'.

Consultants for Healthskills, a health and social care consultancy recruited by local authorities to improve their ability to scrutinise the NHS, has complained that many committees still do not understand the key issues, and are not properly supported, more than 18 months after going live.

The Centre for Public Scrutiny, which has been given£2.25m to develop health O&S committees, has announced a three-year study to judge their effectiveness, and Nigel Grinstead, an independent consultant from Healthskills, said:

'The top 20 per cent of health scrutiny committees are doing very well, but the bottom 20 per cent are struggling.Many are only just starting to function. Some are finding it difficult to work strategically and are randomly picking off targets at the operational level.'

He also fears that some councillors are jumping on the 'band wagon' of popular local issues rather then being driven by the real needs of local people and the local NHS.

He identified a lack of collaborative working with health partners and he said some scrutiny committees were 'falling foul' of party political infighting, working towards vested membership interests that were making them less effective.

NHS Alliance spokesman on scrutiny Dr David Jenner supported Mr Grinstead's views, agreeing that implementation is 'patchy' and that many are working on a 'reactive and localised agenda in places where they are still concerned about saving their local hospital'.

'Many are still finding their feet and are a long way from understanding their roles and responsibilities. Many individuals are not up to understanding the strategic agenda, ' he said But both agreed that where health scrutiny committees were working well, they were making a big difference to improving local healthcare.

The CPS's second annual survey of the local government O&S function is due next month.

Last year it found that capacity and resource issues were undermining scrutiny committees' ability to work effectively, but the CPS's head of scrutiny Tim Gilling said a support programme it was rolling out should convince local authorities of the benefits of scrutiny.

Each O&S committee will receive five days' support from advisers. Mr Gilling said: 'This will allow us to map out the inconsistencies around the country. We are aiming to provide focused support, not a one-sizefits-all approach.'

Another Healthskills consultant, Dr David Stoker, said that not all O&S committees suffered from party politics, but he said the CPS could be doing more direct work with members of scrutiny committees to improve their efficacy.

Local Government Association lead on health policy Jonathan McInerny stressed the importance of the committees in improving public health.

'Consulting with local communities on major developments hasn't been the NHS's forte. Local authorities have long experience of that, ' he said.

But he warned that limited funding could hamstring health scrutiny committees, with many of them sharing their secretariat with other scrutiny panels.

The LGA fears that some may therefore not be geared up to join forces to investigate large projects, such as the reconfiguration of services across Bedfordshire and Hertfordshire.