Agenda item

i)  July 2010 Health White Paper

ii)  'Equality Act 2010: The public sector equality duty' consultation paper

7.1  The chair welcomed Ann Marie Connolly, Director of Public Health, and Sarah McClinton, Deputy Director of Adult Social Care, who each briefly outlined their service areas. Key points raised and queries from members included as follows:

7.2  The director of public health highlighted that public health deals with populations rather than individuals and includes three elements: a) improvement; b) intelligence; and c) protection:

7.3  a) Improvement includes assessing needs, planning services and building strategic partnerships. It contributes considerably to the production of the Joint Strategic Needs Assessment and involves training PCT staff and staff in the voluntary sector. b) Intelligence includes the collation and analysis of health data; comparing this with other areas; and assessing the effect that specific care pathways have on people’s health. It also examines the equity and quality of healthcare, and the quality of performance in GP practices. c) The protection of public health relates primarily to the management of disease outbreaks and immunisation.

7.4  The deputy director of adult social care remarked that in general terms adult social care affects people who need personal care, but that there are specific criteria applied to assess service need and that people are not supported simply because they are old. She highlighted that these services account for approximately 30% of the council budget and pointed to the significance of issues such as safeguarding vulnerable adults: She commented that good progress was achieved in this area over the last year and clarified that the most common form of maltreatment is financial abuse.

7.5  The chair asked what impact would be foreseen on the NHS locally, should there be a 25% cut to the PCT budget. The NHS Southwark chief executive commented that although health had been billed as a service protected from cuts, it may need to stretch given that social care budgets are not protected.

  Briefing on the July 2010 Health White Paper

7.6  Sean Morgan, Director of Performance and Corporate Affairs, outlined key changes proposed in the July Health White Paper (WP). He explained that the commissioning of services is to transfer from the PCTs to GP consortia: these are currently starting to organise themselves and consider what management support they will seek. There will be a Health and Wellbeing board different in form to that which exists in Southwark already, although it remains unclear whether this will also cover children’s or just adult care. This board would also take over the statutory functions of health and social care scrutiny committees.

7.7  The director of performance and corporate affairs also stated that the NHS will be compelled to reduce its management costs by approximately 50%. This was initially to be achieved over a three year period, but NHS London notified the PCT less than a week ago that this is now to be carried out by April 2011, so that the savings acquired can be used to help establish the GP consortia. As a consequence, some PCT functions are expected to dissolve and others may transfer early to local authorities.

7.8  Members referred to the re-formation of the Local Health Involvement Networks (LINks) into organisations called ‘Healthwatch’ and queried what funding had been identified to support these. The medical director responded that there would be money but that it would not be ring-fenced, and commented that there is also currently a debate about whether councils can properly host the Healthwatch, as there could be a conflict of interest if the council is both hosting the organisation and holding it to account.

7.9  The chair asked whether the PCT will be raising these questions in its response to the WP and requested on behalf of the sub-committee that members receive a copy of the draft response before it is submitted.

7.10  The medical director commented that GPs in Southwark are working together in a single borough group and are currently forming a board. She added that they are starting to consider what they are wanting to do and at what pace.

7.11  Members raised queries about the abolition of the Strategic Health Authorities, such as whether the training of midwives and nurses would consequently fall to GPs. The medical director stated that there would be National Commissioning Board, which will be accountable for example, for GPs and dentistry and that training is expected to be provided on a national level.

7.12  It was confirmed that the council leader had signed off the council response to the WP and that a copy would be made available.

7.13  The NHS Southwark chief executive offered to keep the sub-committee informed about the implementation of the changes as they are finalised and how this played out across London.

RESOLVED:

1.  That a copy of the Council’s response to the July 2010 Health White Paper be circulated to all sub-committee members and reserves.

2.  That the PCT keep the sub-committee informed about how the implementation of the White Paper service re-design is taking shape in London.