|
MINUTES
OF THE PATIENTS FORUM MEETING HELD ON MARCH 12, 2003 AT CONSUMERS’
ASSOCIATION
Present:
Jonathan Ellis –
Chair (Help the Aged); Clara Mackay – Vice Chair (Breast Cancer Care);
J.Coe (POPAN); R.Chitels (POPAN); J.Hookway (National Patient Safety
Agency); S.Dane (The Stroke Association); Geraldine Amos (Home from
Hospital Care); E.Neilson (Royal Pharmaceutical Society GB); Hew Helps
(Chiropractic Patients Association); Alison Morris (MND Association);
Jenny ~Singleton (London Health Link); Nikki Joule (The Neurological
Alliance); Malcolm Alexander (ACHCEW); Micky Willmott (Age Concern
England); Roger Steel (Consumers in NHS Research Support Unit); Judy
Walker (Help for Health); Pat Whalley (College of Health); Brian
McGinnis (Mencap); Clarissa Jones (National Council for Hospice and
Specialist Palliative Care Services); Saranjit Sihota (National Consumer
Council); Wendy Garlick (Consumers’ Association); Peter Walsh (Action
for Victims of Medical Accidents); Gerda Loosemore-Reppen (RNID).
Diana Basterfield (Patients Forum) in attendance.
Apologies:
Mike
Took (Rethink); David Pickersgill (BMA); Martin Saunders (As If);
Danielle Swain (Picker Institute); David Pink LMCA)
Guest
Speaker: Kate Mitchinson,
Institute of Rural Health: Rural
Health: Policy and
Community.
See
appendix 1.
Minutes
There
were two sets of minutes: The
minutes of the Patients Forum held on 16th January, 2003 and
the minutes of the Extraordinary General Meeting held immediately
afterwards. Both minutes
were agreed as an accurate record.
Chair’s
report
Jonathan reported good
news: the Department of Health had given the Patients Forum £30,000
for 2003/4.
As was mentioned in
Jonathan’s report in the March Newsletter, this would help to take off
the immediate pressure in terms of the funding and resources of the
Patients Forum but it was not a solution in its own right -it would
provide a bit of breathing space. What this would mean was that since the application for
charitable status was now being considered by the Charity Commission,
the grant from the Department of Health would tide the Forum over until,
fingers crossed, we were approved as a charity.
There was still an awful lot of work to do and the Management
Committee were giving a lot of thought to fundraising and how we might
put ourselves on a more secure financial footing in the future.
Secondly, Jonathan
reported that we were continuing to welcome new members to the Patients
Forum. He added that one of the issues flagged up some months earlier
had been around increasing diversity in the membership and we were in
discussion with the Commission for Racial Equality and the Disabilities
Rights Commission to explore ways of reaching and encouraging
organisations from under-represented groups to get more involved in the
work of the Patients Forum.
Included in the papers
for the meeting had been a list of potential topics for future meetings.
This followed a discussion within the Management Committee to ensure
sure that the issues where speakers were invited were relevant to the
interests of the membership. Members were invited to send in the forms with their
preferences if they had not already done so.
Update on
position regarding CHCs, Patients Forums and ICAS – Malcolm Alexander,
ACHCEW.
See
appendix 2.
Information exchange
Gerda
Loosemore-Repen (RNID): It was reported that the Digital Aids Hearing Programme
was moving ahead. Money had
been allocated and audiology departments would be modernised. People wishing to have more information about this
interesting programme of partnership working between the voluntary
sector and the government should look at the Modernising Hearing Aids
website at@ mhas.org. This
gives updates on where individual Trusts are with adopting new
technology. RNID was in the news for other reasons: financial problems.
Jonathan Coe (POPAN):
It was reported that they had been successful in their
application to the Department of Health for Section 64 monies for an
advocacy and support worker. At
the previous meeting it had been reported that they would be meeting
with the Home Office to discuss the delay in the Criminal Records Bureau
checks and the non-introduction of the Protection of Vulnerable Adults
list. They had now
met with Lord Faulkner and his team and whilst they had gone in
expecting nothing they had come out with a commitment to look at the
possible introduction of an early and limited POVA list and a commitment
to provide a route map to the proper introduction of all CRB checks for
vulnerable people across the board.
It was also reported that POPAN had been working on the Sexual
Offences bill and this introduced three new clauses on the protection of
vulnerable adults, i.e. in the government’s terms people with learning
disabilities and mental disorder. This
had been a good process. Again
the Home Office, led by Lord Faulkner, had taken on board a number of
the issues that various interest groups had raised.
This had now gone to a second reading and
was due to go to committee stage on the 24th of March.
POPAN was continuing to meet with four other national and focused
on abuse issues organisations. These
were Action on Elder Abuse, Respond, the Anne Croft Trust and Voice UK.
This was called the Adult Protection Alliance that was coming
together to focus particularly on campaign issues and on adult
protection.
Julia Hookway
(National Patient Safety Agency): It
was reported that the NPSA was a very young organisation and had
recently joined the Patients Forum as an Associate Member.
They were working on a project to devise solutions to problems
nationally and were currently working on a hand hygiene problem that had
implications for various health workers.
They were keen to have patients involved in every step of the
process and were looking for representation.
If any Patients Forum organisations could assist in this,
particularly those involved with harder to reach groups (especially
older people from black and ethnic minority communities) more
information was available on the Patient Safety website.
Sheila Dane (Stroke
Association): It was
reported that the focus of their work continued to be the implementation
of the NSF for Older People and the stroke standard.
The end of March would see the two year anniversary since the
publication of the NSF with one year left to go before specialist stroke
services “should be” in place (“should be” in place because
there was some concern about the rate towards that goal. The end of
March would also see the focus of their campaigning work being moved to
a local level and a number of their stroke clubs and themselves would be
sending greetings cards to Chief Executives or NHS Trusts and PCTs as a
reminder that they had one year to go.
It was also reported that they were repeating the patient’s
survey that they had carried out about two years previously to see how
far they had come and this would be published in June or July.
They were doing a series of regionally based workshops around
that time too to help those organising stroke services to meet that
target.
Alison Morris (MND
Association):
It was reported that one of the main areas of focus of their
current work was the NSF on Long Term
Neurological Conditions. They
were very keen to ensure that MND was sufficiently covered within the
NSF and they had been fairly active, both within Parliament and further
afield on that. They had
held a meeting with Jackie Smith, the Health Minister, the day before on
this and had had various questions tabled for the debate in January on
how MND would be covered within that NSF.
It was also reported that they had recently published the first
draft of their guidelines on additional support for people with MND who
had lost the ability to swallow and, therefore, needed an intervention
and they would be finalising this towards the end of the year.
This would hopefully coincide with NICE’s development of
guidelines on nutritional support and feeding into that process.
They were also in the process of developing a DNA bank on MND and
hoped that this would be used both by scientists in the UK and further
afield in Europe. This was a major project for them both financially and
in terms of time and effort.
Lastly, they were gearing up for the 20th anniversary
of death of David Niven and had a number of events planned throughout
the year.
Jennie Singleton
(Co-ordinator of London Health Link): It
was reported that most of their current work ws related to transition
and pressing very hard on the Department of Health to get some kind of
arrangements in place.
A big concern was support to people who complain against NHS
treatment and what was going to happen to them, particularly in areas
where no ICAS pilot was in place, and particularly on 1st
September for those who had an independent review.
One of the most interesting projects they were doing at the
moment was one looking at a Community Certificate in Volunteering.
Many CHC members were quite keen to look to the future and going
forward to foundation trusts potentially, for example. This Certificate was being funded by the Learning and
Skills Council and being evaluated by Aston University Business School.
This allowed people to go through a programme of work to show
that they have the knowledge, skills and experience to represent others
in the NHS and speak up for local communities.
There had been a very good uptake – there had only been three
drop outs in total – and they consider that the Certificate offered
good possibilities for the future in many different areas related to
health and representing others. It
was also reported that they had recently produced a briefing on
Foundation Trusts and this was available on their website: www.londonhealthlink.org.
Nikki Joule
(Neurological Alliance): It
was reported that they were very involved in the NSF for Long Term
Conditions. In addition,
they had heard the previous day that the Department of Health was going
to give them some funding to produce a booklet they had written arising
from their Standards of Care Project and the standards of care for
people with neurological conditions.
The booklet would be entitled “Getting the Best from
Neurological Services” and was, probably, the first comprehensive
guide on services available to people with neurological conditions. It was a signposting document that mapped out services in the
NHS and also signposted to education, employment, social services,
sources of information and support and, crucially, the voluntary sector
organisations. The booklet
would be distributed through the NHS and through some of their member
organisations. At the
moment it was not clear exactly how the distribution via the NHS would
work and if member organisations had any information about this could
they please contact Nikki.
(The meeting was
interrupted by the arrival of people for another meeting as Patients
Forum had over run its time so it was not possible to have contributions
from all those attending. They were invited to send in their
contributions to the PF office for inclusion in the Minutes.)
Date of next meeting
Thursday, May 22nd,
2003
Appendix
1
Rural
Health - Patients, Practice and Policy
Kate
Mitchinson, Co-ordinator Rural Health Forum, Institute of Rural Health
Kate began by saying that the
presentation would be very much from the rural perspective but she did
not want people to get the impression that there was a rural/urban
divide on health issues. The
government had encouraged the concept of interdependency between town
and countryside and how the two interlinked and related to each other.
She added that she also did not want to dismiss the concerns of
urban communities. She said
she had, herself, worked in urban deserts where there had been the same
kind of depletion of services and difficulties that rural people
experience.
What had happened over
the previous seven or eight years in the UK was a recognition that rural
areas had particular problems and that a one size fits all approach to
these problems did not always work very well. Kate said her talk would
introduce the Rural Health Forum, look at some of the policy issues, at
the rural practice implications for those and finally at what happens to
patients in rural communities.
The Rural Health Forum is a partnership initiative funded by the
Countryside Agency and the Department of Health and managed by the
Institute of Rural Health. The
Institute was set up in 1996 by a Montgomeryshire GP called Dr.John
Wynne Jones, now that Institute’s Director.
He found that he did not have much training or specific
information about the needs of his rural patients so he took a short
sabbatical and travelled around the world, mostly to Australia and
America where there are long established academic institutes of rural
health, to look at what he could bring back in terms of good practice.
When he came back he decided that nobody else was going to do this for
him so he’d better get stuck in and do it himself.
He, and the now Chief Executive Jane Randall-Smith started out
with two desks and two telephones.
The fact that the Institute had moved so far in such a short time
indicates that there was a real gap there – a gap in our academic
knowledge about rural health and rural communities, a gap in the
education and training that was available to all rural practitioners and
also a big gap in policy and the policy drive for health and how health
is actually being cascaded down into rural communities.
The aims of the Forum are to:
- Raise
awareness of the health and well-being of rural people
- Promote
innovation and best practice
- Provide
a point of national contact for all involved in rural health and
well-being in order to influence policy and practice
- Link
all aspects of rural health and well-being
The members of the
Rural Forum
The Forum is made up of
a national multi-disciplinary partnership, with affiliated members that
bring together statutory, voluntary and community organisations with an
interest in the health and well being of rural communities. The
Forum progresses its aims through influencing at a national and local
level (both policy and practitioners), dissemination of information,
research and demonstration projects.
It is a big partnership to run because it
covers a huge geographical area. The members of the Forum, who join
through “Exchange” (an electronic web-based forum), are based all
over the UK but the work of the Forum is funded solely for England so
most of the partners come from England.
How
the Rural Forum works
This is in two ways.
Firstly they try to tackle some of the strategic blockages at a
national level and secondly they work locally with policy makers in
local government and also with practitioners.
They do so in publications, at conferences and through the
web-based network.
Why
Does Rural Health Matter?
Rural Communities face
specific difficulties in accessing a range of services – including
health and related services. There
is often a presumption that the patient will travel to the service and
this places many rural patients at a disadvantage.
There is a gathering body of evidence to suggest ‘distance
decay’ and its effect on rural patients health outcomes.
The
Rural Health Forum was charged with approaching big agencies, getting
involved with the Department of Health at policy level and able to use
the facilities open to them through the Countryside Agency and latterly
through DEFRA as well.
The
following issues have been identified by the partnership:
- Continuing
centralisation of health services and the lack of a rural proofing
agenda for health
- Transport,
availability of an integrated public transport system
- Access,
to health care and other services essential to health and well being
- Lack
of availability of appropriate services at local level
- Lack
of ‘joined up thinking’ and
‘joined up’ approach to overcome difficulties experienced
by patients and communities
- Lack
of robust data for assessing rural health needs and rural
deprivation coupled with the inappropriate use of urban biased
indices to assess the health and well-being of rural communities
- Lack
of a car is a deprivation indicator in UPA/Jarman, but car ownership
is more likely whatever the income level in the country, because
poor public transport is coupled with lack of local facilities. On
average, rural residents travel 52 miles (or 42%) further than town
dwellers each week (quoted in the Rural proofing guide and
explanatory notes – The Countryside Agency, 2001 Demonstrating
Rural Need. People
in the countryside on low income spend proportionately more on fuel
and car maintenance than town dwellers in similar circumstances. "Car ownership was seen to be essential for
living in a rural area, which means going without things such as
holidays and dental treatment.” Demonstrating Rural [2]
research by Healthy Norfolk 2000, in the Norfolk HImP
- Lack
of a ‘rural premium’ for delivering health services to remote
and rural areas
- Lack
of suitable models of health service delivery in rural areas
- Implementation
of Rural White Paper health initiatives slow to develop or difficult
to access funding for e.g. mobile provision, one stop shops for
health
- Rising
elderly population in many rural areas
Looking
at patients and communities these issues are reflected as follows:
There
is evidence to suggest that rural patients present at a later stage in
their illness resulting in more serious consequences and outcomes for
the patient and ‘distance decay’ in the use of services.
An
example of this is research carried out by Cancer Research UK Study 02:
•Researchers
questioned 95 patients and relatives of patients with the disease in the
North, North East and Northern
Isles of Scotland.
•Delays
in approaching their doctor were more common in the rural patients
questioned, who live
in a very self-reliant way and seem not to like to be a
"burden".
•One
rural patient was reported as saying "I feel I have had this for
about two years but, you know
how it is, you don't like to bother the doctors."
•This
reluctance to be pro-active in seeking cancer care is very different to
some of the attitudes of
urban patients in the same situation. Dr Neil Campbell, Cancer Research
UK Fellow of Oncology
Practice
-
Cost savings to the health service are often passed onto the
rural patient in terms of travelling difficulties and expenses to
access services at all levels.
There is a presumption that the patient
will travel to the service
-
Lack of a joined up approach leads to poorer health and well
being
outcomes for rural communities including: transport, housing,
district nursing provision, access to shops and food etc
-
Poor access to support in the home and access to social
care/residential care for vulnerable members of the community
-
Lack of information on help and support services
Difficulties
experienced by rural GPs
•Difficulties
in recruitment and retention of staff
•Training
for rural health practitioners that meets the needs of those at a
distance from central services such as accident and emergency
departments and acute units
•Out
of hours services
•Impact
of centralisation of services and clinical governance on rural practice.
This is not just about the NHS location of services it is also
about the impact of what comes down in terms of guidance from the Royal
Colleges which can mean that some services are just not viable.
There has been a move with the Paediatric services to move them
to large centres of excellence. These
provide good services for patients but can mean families having to
travel huge distances to access pretty basic checks,
tests, run of the mill things.
One of the partners on the Rural Health Forum is a Paediatrician
at Britain’s most remote hospital – Whitehaven in Cumbria.
She has just fought a rear-guard action, quite successfully, with
her community’s backing to prevent the service moving up to Carlisle,
which would have meant a really extended journey.
•Professional
isolation is a problem for all practitioners in rural areas
Kate concluded by
saying that those were the difficulties and what the Rural Health Forum
was charged with, together with the agencies across the partnership, was
developing a ‘solutions focused approach’ to these difficulties.
They also wanted to encourage others and collate the information
about good practice to get it out to, in particular rural PCTs and
strategic health authorities.
A few months earlier they had produced a booklet entitled “Think Rural Health” in conjunction with the Countryside Agency.
This had gone out to all rural PCTs, SHAs, government offices and
other agencies with an interest in rural health. This was the start of
their work in engaging with them on the idea of rural proofing their
practice and policies.
A second area of
current work was a Rural Proofing for Health Project with funding from
the Department of Health. This
was the first generic health project.
The aim was to produce a tool kit, a range of examples and an
advice and information service to rural PCTs so that if they had a
sticking point or a problem they could go to the Rural Health Forum and
there would be a body of evidence there to show that things could be
done.
They
were also engaging with policy by working with the
DoH, Strategic Health
Authorities and particularly the
PCTs; with DEFRA’s Rural Affairs Forum for England chaired by Alan
Michael, the Minister for Rural Affairs and Elliot Morley, the
Agriculture Minister. The
Rural Health Forum was the sub group of the Rural Affairs Forum for
England.
They
were also engaged with the Countryside Agency’s Rural Proofing Report
on a wide range of issues. They
were charged with producing the rural proofing report every year and
this looked at how government departments were implementing rural
proofing. Were they
considering rural communities when they developed policy?
Areas such as NSFs and all the policies coming from the centre
should have been looked at from a rural dimension before coming down
into the local governance of strategic health authorities and PCTs.
They had just completed a report on this for their Chief
Executive, Richard Wakeford.
Resource
Allocation was a key issue. There
was currently no rural premium, apart from the rural practice payment to
GPs. Before the changes in
health structures the rural health authorities got together and
commissioned Plymouth University to write a report on resource
allocation. This had
gone to the Department of Health last autumn to try and influence the
next spending round for primary care set last November.
Unfortunately it did not get anywhere but the Rural Health Forum
still considered it to be a very important lobbying point and they were
continuing with that work.
They
were also engaging with practice. The
Royal
College of General Practitioners was a great support to the Rural Health
Forum. At the beginning of
April, six of the partners from the Forum would be meeting with six of
the heads of the Royal Colleges to look at the issue of clinical
governance and the impact of centralisation on rural services.
It was hoped this would begin to open a dialogue about the impact
on access for rural patients.
They
were also promoting and disseminating innovative and best practice in
rural health. At the
Institute of Rural Health there was a research arm and also an education
arm with the Welsh Rural Post Graduate Centre for doctors and dentists.
They were continually looking for what was out there and offering
training and support on a whole range of issues.
Patients
For the Rural Health
Forum and the Rural Health Institute, patients probably constituted
their gap. There was
patient involvement through the membership scheme at the Institute and
through the Rural Health Forum
Exchange (electronic UK wide network). However, being an agency very
much involved in academic work, policy and professional training, it was
quite hard to work at the community level with patients. They were very
concerned that the rural voice should be heard in the new patient
representation structures and there would need to be models for outreach
and good practice to ensure patients’ voices were listened to.
They would very much like to have representation on the Rural
Health Forum from the Patients Forum, as they did not feel they had done
this adequately. Anyone
interested in doing this should contact Kate Mitchison on katem@irh.ac.uk
Conclusion
Two
years earlier when the Forum was started they had only just begun their
dialogue with the Department of Health.
The rural White Paper was new and DEFRA did not exist.
Through these two years, really because of the diversity of the
partnership they work with and the firm link to the practice base and to
the community through the electronic exchange they had been able to move
forward on the policy level and the influencing at a very rapid rate.
Appendix
2
Malcolm
Alexander, Director, Association of Community Health Councils in England
and Wales (ACHCEW)
Update
on position regarding CHCs, Patients Forums and ICAS, 12th
March 2003 at the Patients Forum meeting.
Malcolm
began by saying that he wanted to produce a few headlines about what was
currently happening in the development of the new patients and public
involvement system and express some of ACHCEWs fears and concerns. ACHCEW was in total support of the Commission for Patient and
Public Involvement in Health (CCPIH) and of Patients’ Forums but they
wanted to make sure that they would be introduced in a way that would be
most beneficial. There
were quite a number of problems that they had been grappling with.
There
had been two recent debates in Parliament on this issue; one in the
Commons and one in the Lords and it was worth looking at these debates
because they provided a detailed insight into the outstanding issues.
February
2003 – Questions and Answers on the Commission for Patient and Public
Involvement in Health (issued by the CPPIH)
‘It
has developed a tiered structure to empower existing local networks to
deliver patient and public involvement and set up local Patients’
Forums.’
‘Nine
regional units, independent but responsible to the Chief Executive, will
deliver patient and public involvement within their regions. This
responsibility includes managing the delivery of Patient’ Forums.’
‘Local
networks, contracted by the CPPIH, will be responsible for enabling
patient and public involvement within the local community by providing
locally based administrative and infra-structure support to the Patients
Forum.’
‘The
brief for the local network, will be available shortly, but will
include…the establishment and support of Patients’ Forums.’
‘The
target is to have local networks in place by September 1, 2003 with a
view to establishing Patients’ Forums as soon as possible.’
Malcolm
described the CCPIH structure of nine regional offices and the hub in
Birmingham where the directly employed staff would be based. He stated
that the bombshell was that the staff for the local Patients’ Forums
would come through a different mechanism. Originally Ministers had given
very clear assurances that there would be directly employed staff for
Patients’ Forums and those assurances had been reneged upon by
Ministers. One reason for this was the CPPIH’s budget. Peter Walsh and
others in ACHCEW had produced some very detailed figures which showed
that about £60 million would be needed to run the Commission and the
Patients’ Forums effectively and to provide a sufficient number of
staff at local level. Despite a huge amount of campaigning and very hard
work by Sharon Grant (the Chair of CPPIH) and ACHCEW the budget was
still only £34 million (this included support for the CHCs until
September 1st 2003). That
was not enough to run the system effectively.
The
current situation was that CHCs would close on September 1st
and the new Patients Forums would be coming on line sometime after that
- it was hoped by the end of 2003.
In the House on Monday, the Minister (David Lammy) had said that
some Patients’ Forums could be established by 1st of
September but that was clearly impossible because the system being set
up by the CPPIH made this almost impossible. CHCs would gradually
disappear over the coming few months, as they would be unable to sustain
their workload as staff left – CHCs would go into a terminal state of
decline. The new system was clearly not going to be up and running in
time so there would be a serious gap between the closure of CHCs and the
establishment of Patients’ Forums.
Another
very clear Ministerial promise had been that Patients’ Forums would be
established as ‘one stop shops’ i.e. new system would be easily
accessible to patients and the public and have a clear presence in local
communities. This did not mean that there had to be shopfront in every
area but it did mean that access had to be very obvious to everybody.
¨
22nd
May 2002 – One Stop Shop
Hazel
Blears MP NHS Reform and Health Care Prof Bill (col. 326)
‘Every
PCT Forum will have staff who will commission or provide independent
support to help individuals make complaints. They will work to empower
the local population to express their views about health issues, and
will provide the one-stop shop
service by giving advice and information about public involvement,
the complaints process and how people can participate.’
What
had now happened, and this was a very important point, was that
Patients’ Forums’ and the ‘one stop shop’ concept were now being
confused with PALS, which are tto provide information for patients and
are part of the NHS, but are not independent. Ministers were now
confusing the independent and non-independent parts of the new system as
though they were now one system. Previously there had been very clear
pledges by Ministers that this would not happen.
“I
hope that I can reassure noble Lords that I accept the point that we
should have no intention of abolishing CHCs before the new arrangements
are up and running. We intend there to be a well – managed transition
between the existing system and the new system. The NHS has experience
of restructuring so we understand how the process operates. We would
seek to ensure that good, administered principles operate in relation to
the phasing out of CHCs and the introduction of the new arrangements.
Our intention is that the bulk of the new arrangements will have to be
up and running before the existing arrangements are taken out of
play”. Lord
Hunt of King’s Heath, Hansard, 19th March, 2001.
Overlap
between CHCs and Patients’ Forums
¨
30th
October 2002 – Overlap between CHCs and Patients’ Forums
David
Lammy (77430) reply to Dr Evan Harris (PQ)
‘CHCs
will be abolished once the new system is functioning. The date of
abolition for CHCs and ACHCEW has yet to be decided but we will make an
announcement as soon as a date has been set. In the meantime the 184
CHCs continue to function and will be funded until their abolition.’
¨
22nd
May 2002 – PCT Patients’ Forums
Hazel
Blears MP NHS Reform and Health Care Professions Bill (Col 349-50)
‘There
will be staff employed by the Commission for Patient and Public Involvement in
Health who will work with PCT Patients Forums, supporting all of the
Forums in the area, commissioning and providing independent complaints
and advocacy services and crucially, promoting public involvement in the
whole of the health service and those wider issues that determine health
in local communities. The staff will be a key part of the system, but
they will be grounded and rooted in PCT Patients Forums close to their
communities.
Ministers
had promised that there would no gap between the old system and
Patients’ Forums/ICAS. These promises had been made many times in
Parliament and in letters to ACHCEW from Ministers and had not been
kept. It had
been made very clear by Ministers that there would not be a gap, that
users, patients and carers would not be left in a situation where they
did not have a reliable service to relate to. Instead the Government had
let CHCs go into a gradual decline rather than to ensure an effective
transition to Patients’ Forums. This would have been so easy to
achieve. The problem was not caused by a shortage of money but by
incompetence. David Lammy described the objectives of the CCPIH
as:
-
To champion and
promote the involvement of the public in decisions which affect
their health
-
Putting the public
at the heart of decision making in local NHS services
-
Shifting
the balance of power in the NHS in favour of patients and the
public to give them real influence and power
-
Giving patients and
the public the right to be fully involved and consulted about how
local NHS services are planned, delivered and can best be improved
-
Ensuring that
patient and public voices are supported, encouraged and enforced
-
Ensuring national
standards are controlled locally
-
To modernise public
involvement in health and get a many people involved as possible
-
Empower the public
to have their say by training them with the skills they need to get
involved
-
Supporting patients
and the public to make sure their voices are heard
-
Working with
traditionally marginalised groups to ensure that getting involved is
as easy as possible
Resources
and the Gap
¨
22nd
May 2002 – Resources
Hazel
Blears MP NHS Reform and Health Care Prof Bill (col. 344,5,6)
‘Nevertheless,
I have acknowledged that more resources will be needed to ensure that
the system works properly and that we do not get consultation and
involvement on the cheap, so we will need to invest extra resources.’
‘However,
we value a robust, independent and vigorous system of patient
involvement, and clearly its implementation will cost more that the
existing system. That is evidence of our commitment to investment.’
‘At
present, CHCs receive about £23 million; we allocated an extra £10
million to fund the patients advocacy and liaison service. The staffing
of the Patients’ Forums will require additional resources, but I am
not in a position to go into further detail.’
‘…the
staffing support will be adequate to enable the Forums to carry out
their functions. That is the key part of the equation. It would be wrong
to give bodies responsibilities without the resources to discharge them.
No sensible government would ever do that.’
‘Our
proposals are evidence of our commitment both to reform the system –
this measure is a major reform – but also to the investment that makes
reform work.’
ICAS–
the commitments
¨
22nd
May 2002 – Independent Advocacy
Hazel
Blears MP NHS Reform and Health Care Prof Bill (col. 319-20)
‘
– the staff of the PCT forums will be able both to provide and to
commission independent advocacy support. During
various stages of the Bill’s consideration many Members have talked
about incorporating the duty to represent the views of local people, and
the provision of independent complaint and advocacy support – this
would make sense. We genuinely picked up on that idea.’.
Independence
- Annual Work Programme and Relationship with Patients’ Forums
¨
21st
January 2002 – Independence of the New System
Lord
Hunt of Kings Heath (col. 355)
Transfer
of Skills and Knowledge of Staff and Members
¨
6th
December 2001 – Skills, Experience and Expertise of Members
Hazel
Blears MP (Col 280)
‘I
want to give the assurance that, in many cases, the members of Patients
Forums will be existing members of Community Health Councils. I have no
doubt about that. We are specifically trying to provide a transition
path, as hon. Members will see from the implementation plan. We want to
work with Community Health Council members to see whether they can find
a place within the new system that enables them to bring in their
skills, experience, expertise, and depth of knowledge. We would be
foolish in the extreme to discard the depth of knowledge that members of
Community Health Council have acquired over many years.’
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