Agenda and minutes

RESOLVED:- that the Minutes of the meeting held on 20 July were correctly recorded and that they be signed by the Chairman.

(Item 4 – Report by Overview and Scrutiny Manager)

            (1)       The Chairman introduced the paper on restructuring and refocusing the Committee. He highlighted the need to update the protocol for the operation of the Committee, which dated from 2001. Discussions were to be held with District Council colleagues in relation to the potential to formally delegate to them some of the statutory powers of the NHS Overview and Scrutiny Committee.  The Chairman emphasised that the Health scrutiny function must operate independently of the County Council’s Executive; the Committee’s independence was a vital element in discharging its role.  In relation to the Work Programme, there had been discussions across the political parties and with health colleagues from East and West Kent to obtain their views.  Tabled at the meeting was a list of potential items which had come out of these discussions.  The Chairman stated that he had been impressed with the way that Parliamentary Select Committees worked and he would like the Committee to work in a similar style.  This would involve setting an agenda at least two to three months in advance and there being a greater understanding of the issues by Members prior to the meeting. This would give Members more opportunity to ask questions, rather than listening to presentations.  He referred to the comments of Ms Ross, the Director of Civic Engagement for West Kent PCT, in relation to the way that the Committee worked, which had been circulated to Members. He emphasised that, while NHS colleagues would have an input into the Work Programme, it would also reflect the fact that part of the role of Members of the Committee was to represent patients’ and residents’ views, and to consider broader issues, including that of value for money.

            (2)       Members were then given the opportunity to discuss and comment on the issues raised in the document. In relation to the issue of access to health services, particularly as regards transport links, Members, as well as health service colleagues, had a role to play in helping to educate the public about the changing role of the Ambulance Service. This was particularly so in respect of the skill-set that ambulance staff now had and the impact of this on A&E services.  It was noted that the South East Coast Ambulance Trust covered three counties and that, given this, the Kent Locality Group of the South East Coast Ambulance PPIF had a particularly important role to play.

Division of work between County Council and District Council Scrutiny Committees

            (3)       The Chairman reported that a meeting was being arranged with District Council colleagues to discuss the way in which a joint work programme, with delegation of certain items to District Scrutiny Committees, could operate.  He stated that there was no fixed timescale for this but it would need to be dealt with as soon as possible.

            (4)       During discussion of this item the following points were made:-

•           Over the last few years there had been much duplication of  ...  view the full minutes text for item 49.

(Item 5 – Mr Graham Gibbens, Cabinet Member for Public Health, and Mr Mark Lemon, Policy Manager, Kent Department of Public Health, were in attendance for this item)

            (1)       Mr Gibbens referred to the Tackling Obesity Select Committee report which had been published in December 2006 and commended the excellent job done by the Select Committee.  He stated that the recommendations made by the Select Committee had been a useful tool to highlight the roles of the various agencies involved.  He referred to £900,000 that had been secured from the Big Lottery Fund to finance a wide range of programmes and projects designed to improve levels of physical activity, nutrition and mental wellbeing across the county.  This was a result of successful partnership working between the Primary Care Trusts, KCC Directorates and the Kent Department of Public Health.  He informed the Committee that for the first time in three years the full allocation of Choosing Health money to PCTs had been designated for use on public health interventions.  Attached to the report before the Committee was an action plan which detailed the main activities currently being undertaken to support the recommendations in the Tackling Obesity report.  A Kent-wide Obesity Strategy was currently being drafted and should be issued for comment very shortly.

            (2)       Members asked a number of questions on the action plan. Mr Gibbens acknowledged that some of the recommendations were challenging and that it was important that this was brought out in the action plan and response to the recommendation.  Mr Lemon stated that some recommendations were being taken forward in other ways – for example, in relation to Recommendation 7, the NICE guidelines on GPs prescribing exercise to patients should move this forward at a national level.  The Obesity Strategy would set out these issues and also would have an action plan that had measurable outcomes.

            (3)       In relation to a question on the Choosing Health money for Kent PCTs Mr Gibbens confirmed that details of how this money was spent would be submitted to Cabinet and to the Committee.

            (4)       RESOLVED:- that the progress made on the recommendations of the Tackling Obesity Select Committee report be noted.

(Mr Mark Devlin, Chief Executive, Ms Susan Acott, Director of Performance and Service Development, and Ms Jenny Kay, Director of Nursing and Workforce, Dartford & Gravesham NHS Trust, were in attendance for this item)

(1)       The Chairman welcomed Mr Devlin, Ms Acott and Ms Kay to the meeting. 

(2)       Mr Devlin referred to the paper produced by the Trust, which had been circulated with the agenda for the meeting, and gave some background to the Foundation Trust application.  He stated that he was primarily looking for views on the Trust’s proposed service strategy in terms of the areas of service that the NHS Overview and Scrutiny Committee might like to see developed.  He pointed out that it was proposed to give the County Council the opportunity to be represented on the Foundation Trust’s Council of Governors.

(3)       Members then asked Mr Devlin and his colleagues a number of questions in relation to the financial status of the Trust, the rationale for Foundation Trust status and the future relationship of a Foundation Trust with the NHS Overview and Scrutiny Committee as regards accountability.

(4)       Mr Devlin gave assurances about the financial status of the Trust and stated that the Trust Board would not be proceeding with the Foundation Trust status application if they were not confident of their financial situation. He confirmed that the Trust had moved from a £4 million in-year deficit (equivalent to 4% of turnover) in 2005–6 to an in-year surplus of £250,000 in 2006–7. The Trust still had a £1.8 million underlying deficit (resulting from the Resource Accounting and Budgeting regime, which had now been removed from the NHS), but anticipated clearing this in the next two years by means of achieving further in-year surpluses. An in-year surplus of £500,000 was anticipated in the 2007–8 financial year. Responding to a question on what management action had been taken to move from deficit to surplus, Mr Devlin explained that this had had a series of strands. Expenditure on pay had been curtailed by means of reducing temporary (bank and agency) appointments, carrying out a workforce review and making a number of posts redundant.  Mr Devlin said that a very aggressive programme of redeployment had meant that few individual members of staff had been put at risk of redundancy.  In response to a question on what arrangements there were if a Foundation Trust went into deficit, Mr Devlin replied that the NHS would still act as a guarantor regarding repayment of any debts and that the Foundation Trust would have to demonstrate to “Monitor”, the regulatory body, that they could service any loans that they sought.  He emphasised that as a PFI hospital they had only a small number of assets that they actually owned and therefore the issue of the Foundation Trust being able to sell off assets would not arise.

(5)       Mr Devlin was asked whether the Trust would be aiming for services currently provided at London hospitals to be provided by Darent Valley Hospital.  He confirmed  ...  view the full minutes text for item 51.