Agenda item

8.1  James Postgate, Principal Strategy Officer and Stephen Gaskell, Business and Partnership Manager went through a presentation on the establishment of a shadow Health and Wellbeing Board (appended to the minutes).

8.2  Officers explained that the move of public health to the council is partly because of the 2010 Marmot Review which set out the limitations in tackling health inequalities in the current system in which “the perception among agencies is that responsibility for the delivery of health improvement lies with the NHS”. The Marmot Review highlighted that local government and other public sector partners hold many of the levers that shape and can have an impact on health inequalities.

8.3  Officers reported that health outcomes in Southwark are improving, however there are significant health inequalities. Officers reported that as  you move around Southwark you lose a couple of years life expectancy for every two miles shift in location.

8.4   Officers drew members attention to the diagramme in the power point which outlines the board’s role and its relationships to other bodies. The Health and Adult Social Care scrutiny committee has a role in holding the Health and Wellbeing Board to account.

8.5  In developing the board officers reported that they had been referring to the Health and Social Care Bill passage through parliament and the ‘Operating principles for health and wellbeing board’.  These sets out what a board and strategy must do. Officers reported that there are some ‘musts’ but quite a lot of local flexibility. They explained that the membership is set by cabinet. Officers reported that the Board is an odd mix of officers and members and this is a new governance arrangement for the council to manage. 

8.6  Officers explained that there was a cabinet decision in November 2010 that the Cabinet Member for Health and Adult Care would oversee a programme of work.  In order to start work to establish a new Health and Wellbeing Board in September 2011 the Cabinet Member formed a Planning Group.

8.7   The planning group has been looking at parameters, the focus of the board and what should be its priorities. The Planning Group set out a number of initial areas to explore to help to understand the health and wellbeing challenges in Southwark. Focus groups and workshops with key stakeholders, including with community groups, have taken place in order to listen to other people’s views on these and other areas.

8.8  Officers reported that these are the areas identified so far :

- Older People

- Early Intervention and Families

- Physical Activity/Healthy Weight and Exercise

- Alcohol

- Smoking

- Coping skills, resilience and mental wellbeing

- Housing and home

- Economy and jobs

8.9  The chair invited questions from the committee and a member asked if a lay person could be appointed, for example,  a patient representative or someone such as Tom White from SPAG who will have a community perspective. A member said a youth representative might be useful. Officers responded that Healthwatch will get a place and there is local choice on the membership. A member expressed the view that there should be more than one councillor on the board or indeed a majority of councillors reflecting the political balance in order to tackle the health democratic deficit. A member reflected that we need to think about the balance of power and how we put the communities’ voice in place.

8.10  Members asked officers if it was possible to be on the health and wellbeing board and on Health scrutiny. Officers said they would take advice on this.

8.11  A member commented that the board would need to think about how do you mitigate the power of clinicians. She went on to comment that General Practitioners can be very medical model and the council need to think about the Social Model’s place and emphasise prevention. Another member agreed and referenced the success of the  veterans model of public health.

8.12   Officers asked members for suggestions on topic and alcohol was strongly recommended by a member because of its overall impact on health and social wellbeing. Another member recommended obesity and went on to highlight the need to tackle the environmental cues and causes, such as the proliferation of chicken shops, and the need to work on prevention so that we create an environment that promotes health. Members asked officers for more information on the topics identified so far.

ACTION

The chair will write to the Leader with the scrutiny committee’s recommendations

Officers will provide more information on the topics.

Clarification will be obtained on if a member can sit on the Health and Wellbeing Board and the Health and Adult Social Care scrutiny committee