Minutes:
Mr D L Brazier, Mr B R Cope, Mr A D Crowther, Mrs E Green, Mr C Hibberd, Mr R J Lees, Mrs J A Rook and Mr A Wickham were present for this item as local Members.
1. Mr Lemon presented a series of slides which summarised the content and aims of the White Paper, the structure and arrangement of the new Public Health system and the new responsibilities which this brought to Local Authorities. He responded to comments and questions from Members. Points highlighted were as follows:-
a) the new arrangements will be scrutinised at two levels; by the Health and Wellbeing Board (HWB) and by the KCC’s scrutiny process;
b) GPs’ consortia would have the power to govern themselves and take commissioning decisions at a local level but will be ultimately answerable to the NHS Commissioning Board and the Secretary of State. Consortia must take account of the priorities of the Joint Strategic Needs Assessment, and the HWB have a duty to see that this is done. Every GP must be part of a consortium and every geographical region needs to be covered by one. Some members expressed the concern that this decision-making process might mean GPs having less time to spend helping patients;
c) the membership of the NHS Commissioning Board is decided by the Secretary of State, and includes/will include reps from the Care Quality Commission, among others;
d) the role of KCC Members would change, particularly in terms of scrutiny?, and further briefings will be arranged to help Members understand the new role as the detail of it becomes clear over time, as the new PH arrangements bed in. A report of the future scrutiny arrangements would be submitted to the Scrutiny Board;
e) the HWB will be a statutory committee of the KCC, and the relationship between the two will be very important. This will require a change to the KCC constitution, and the work of the HWB will be reported to the full Council;
f) the picture of current commissioning is as yet incomplete, as more information is available on the arrangements in East Kent than there is available for West Kent. Work is ongoing to add to the picture;
g) It is expected that KCC will work closely with Medway … on public health issues… ? but the statutory responsibility rests with the KCC;
h) the complexity of the new arrangements and number of new bodies are very confusing for the public and for Members. What is key for the public is to have efficiency, speed and good access. Members will need to be able to explain the new arrangements to local residents when asked;
i) Some of the new framework is set by government and can only be changed by them, while other is at the discretion of the KCC and could be established to suit local priorities;
j) although much time had been spent gathering data, it is important that this data be used to generate useful information which can help to shape services; and
k) the new arrangements could be used as a platform from which to reinforce the prevention agenda, and this would be a good role for the KCC to take on.
2. Mr Gibbens added that health inequalities were a concern for everyone in a community, and KCC Members would have a role in addressing this. This POSC will need to provide an ongoing scrutiny function as the new system is established.
3. RESOLVED that the information set out in the presentation and given in response to comments and questions be noted, with thanks.