Health White Paper published

Last updated:13 July 2010

The Health White Paper, “Equity and Excellence: Liberating the NHS” has been published.
 
While many of its central components were expected, the scale and speed of the reforms being planned is more significant than many commentators envisaged. It puts in place a future for the NHS as a “public health service”, centred on the role played by GPs as commissioners of health services from providers who can be from any sector.
 
Key components include:
 

• Abolition and SHAs and PCTs and their replacement with GP consortia which will commission services;
• Local authorities given a strengthened role to direct public health policy and to oversee commissioning in partnership with GP consortia;
• A strengthened, two-arm regulatory system made up of Monitor and the Care Quality Commission, who in addition to an amended regulatory role will also have a responsibility to vett potential healthcare providers;
• The reorganisation of LINks as Local HealthWatch, funded directly by local authorities.

 
As part of these proposals, the current statutory role carried out by health scrutiny committees in county and unitary authorities is being abolished. The role of the local authority in maintaining oversight over local health issues is envisaged in the White Paper as involving councillors – however, it does not specify backbench councillors.
 
Although this is supposition, it is likely that the abolition of statutory health scrutiny is being carried out to make it easier for those authorities that wish to return to the committee system to do so.
 
Of course, there is nothing to say that this means that scrutiny councillors will not be able to take a role in the scrutiny of health services in the future. Councillors will still, as local community leaders and as the only actors in the local governance landscape who will have the credibility and legitimacy to hold public services to account, have an important role to play. However, it is likely that what this role entails will need to be agreed at local level, in consultation with local people and Local HealthWatch.
 
It is, to say the least, extremely disappointing that statutory health scrutiny, which has more than proved itself since 2001, is being done away with. However, the lead-in time (the bulk of the provisions in the White Paper are expected to come into effect in April 2012) should allow scrutiny practitioners and others to put together a coherent picture for health accountability that involves local backbench councillors alongside others.
 
We at CfPS will help local authorities and their partners to do this, as the proposals develop. We will also seek clarification from DH on the detail of the plans, and will ensure that formal accountability is not forgotten as the NHS undergoes what some commentators are calling its most significant reorganisation since 1948.
 
There is currently a thread in the Scrutiny Exchange forum where this issue is being discussed - Health White Paper and you can read our response to the paper here.
 
The White Paper itself can be found here: Equity and Excellence: Liberating the NHS