To discuss the implications for the Council and the public of the changes contained in the Government White Paper “Equity and Excellence: Liberating the NHS”.
The Executive Councillor for Housing & Public Health, Councillor A Hansard will introduce Dr Simon Brown, Chairman of Hunts Health who will address the Council and, together with colleagues, answer Members’ questions.
Minutes:
(Councillor J A Gray took his seat in the Civic Suite at 7.15 pm and Councillor Mrs J A Dew left the meeting at 7.55 pm.)
Councillor A Hansard, Executive Councillor for Housing and Public Health welcomed Dr S Brown, Chairman and Mrs E Sergeant, Managing Director of the Local GP Consortia: Hunts Health to the meeting to lead a discussion on the implications for the Council and the public of changes proposed in the Government White Paper “Equity and Excellence – Liberating the NHS”. Before inviting Dr Brown to address Members, Councillor Hansard reminded the Council that the White Paper proposed a major restructuring, not just of health services but also of Councils’ responsibilities in relation to health improvement and the co-ordination of health and social care as well as plans to reduce unnecessary bureaucracy and devolve power for the delivery of health services locally.
With the assistance of a powerpoint presentation, Dr Brown explained that Hunts Health was a pilot organisation tasked with forming a consortia of GP practices which would work with other health and care professionals and in partnership with local communities and authorities to commission NHS services for their patients. He added that NHS Cambridgeshire would maintain statutory responsibility for all PCT functions until new statutory organisations were formed and that, thus far, ten practices were members of the consortia with several expressing an intention to join in the future. It was Dr Brown’s view that this approach to health care could generate efficiencies across the NHS and improve social care and public health through stronger joint working.
In closing, Dr Brown welcomed the opportunity offered to address the Council at an early stage in the development of this process and indicated that he looked forward to building on the relationship which already existed between the NHS and the District Council.
Councillor G S E Thorpe asked how the new polyclinics envisaged by the Health Minister, Lord Darzi, would be funded. In response, Mrs Sergeant replied that it was her understanding that there would be a national formula for the allocation of funds based on prescribed criteria which would comprise a variety of measures including deprivation. Dr Brown added, in response to a question from Councillor M F Shellens, that he could not identify any major differences between the consortia proposals and the polyclinic model and although health care would remain free, GP consortia would have experience of patient care with clearer links to Hinchingbrooke Hospital and social care agencies in the community.
In terms of the future role of the District Council, Dr Brown envisaged that the new approach would encourage GPs to get involved in all aspects of the community including housing, the environment and social inclusion issues all of which would demand the input of the District Council, local strategic partnership and neighbourhood management initiatives. He added that it was important that each organisation should co-operate and work positively together to avoid duplication of services for the health and well-being of all Huntingdonshire residents.
Following a question from Councillor R J West regarding the potential for conflict between the role of GPs in terms of health treatment and finance, Dr Brown accepted that there could be a conflict between the commissioning and service arms of the consortia but that GPs would not necessarily have an involvement in the process nor the decisions taken by the Hunts Health Board in this respect.
Referring to the Yaxley consortia, Councillor Mrs M Banerjee asked whether community care staff would be transferred to the new practice. Mrs Sergeant replied that this would be dependent upon an assessment, by the consortia, of the services they might wish to commission and provide. Furthermore and in response to a question by Councillor T V Rogers in respect of occupational therapy, Dr Brown added that the NHS also had to manage financial constraints imposed by the new Government efficiently and innovately as possible to effect the levels of services which could be provided particularly for the elderly and that the occupational therapy service would be one which would be considered at an early stage of the process.
Councillor P M D Godfrey drew attention to a perceived disparity of treatment and standard of health care available around the country which had led to some being more proactive than others in early diagnosis of health problems. He questioned whether Hunts Health would seek to encourage consistency across GP practices and discontinue local rationing to avoid raising patients’ expectations about the level of service they may be likely to receive. In reply, Dr Brown acknowledged that there was a requirement to standardise care and, whilst levels of primary care in Huntingdonshire were good he was aware that services in some areas were more variable. He added that the new consortia approach would present an opportunity to improve standards across the District and that this represented one of the objectives of the new organisation.
Councillor Hansard drew attention to the proposal which suggested that the consortia would be required to monitor their own performance. Dr Brown indicated that he was unable to comment in detail on how this would be achieved but it was his expectation that guidance would become available to assist and encourage GPs to participate in a form of appraisal process.
Whilst commending the new approach, Councillor P J Downes raised two concerns relating to the importance of the relationship between GP practices and children’s centres and the need to maintain enhanced levels of participation in patient groups. Dr Brown confirmed his support for the retention of both initiatives and reported that there would be a non-executive patient representative on the Hunts Health Board.
As Leader of the Council, Councillor I C Bates indicated the Council’s willingness to engage with the consortia adding that the authority’s involvement was essential to improve the health of residents in the District. He suggested that the new proposals represented, in his view, a return to GP group fund holding and that he would hope for their continued involvement in public health prevention so that issues relating to young smokers and obesity could continue to be addressed. Whilst there was some danger that preventative work might be lost, Dr Brown was hopeful that both local authorities and other agencies could progress joint initiatives but this would be subject to further discussions between partners.
Having commended the contents of the White Paper, Councillor P D Reeve asked about the practicalities and risk involved in its implementation. Dr Brown was of the view that the greatest risk to the process was failure, the loss of expertise and the difficulty in managing resources, including staff. However, if the proposal was to succeed it could result in less expensive, accessible and local health services.
To conclude the debate, Councillor Hansard thanked Dr Brown and Mrs Sergeant and colleagues for attending the Council meeting and for answering Members’ questions.
Actions:60 minutes