WORKSHOP ONE: PARTICIPATION
LED BY CHRISTINE HOGG AND DONNA COVEY
Should health authorities be directly elected?
In Kidderminster we have 19 elected members on Wyre Forest District Council, with 42% of the poll.
At present our democracy is too "top down".
Christine Hogg: Language does matter. "Community" is stronger than "patients". A community approach recognises that there may be many different interests., and may imply that people want to see value for their taxes. Good CHCs have encompassed these different interests, including patients and others. CHCs have taken a wide view of health. A patients forum is much more restrictive.
Martin Rathfelder: The notion of community needs some unpicking. People may be members of many different communities.
Everyone is potentially a patient.
Public health is not just about the NHS. How would the new arrangements encompass public health?
Gavin Ross: CHCs campaign about issues in Primary Care like dentistry and PCTs. How are they to be covered by forums?
Cedric Bristow: Being a member of a Health Authority is demanding and difficult work. If people were elected they would need real training. Complainants are often bamboozled by managers and professionals. CHCs are a real asset to the complaints procedure.
Tony Arnold: CHCs have managed to deal with the stigma of mental illness effectively. Many of these patients are unable to shout for themselves.
Sally Brearly: Patient is a role we all play from time to time
Christine Hogg: Who chooses who should be consulted? A lay member of a body is not the same as a consultation process. Are naïve amateurs useful? How are lay people accountable? Where do they get their information from?
Donna: We are stakeholders firstly as taxpayers, secondly as users or patients - mostly periodically, thirdly as voters. The distinction between patients and citizens is false. The collective voice is important. Politicians or Chief Execs must not be allowed to play citizens off against patients.
David Spilsbury: None of the monitoring exercises local CHCs organise would happen under the section 10 proposals. His Community Health Council runs a programme of activities actively examining a range of services.
It is important to elect people from the voluntary sector. Lay representatives on PCGs is no substitute for community involvement.
Nicky Joule: How are lay people to be elected, trained and supported? How is the process to be held together?
Pauline McNicholl: Electing people is not identical with democratic involvement.
CHCs play a big part in preventing mishaps because of their monitoring visits. Forums will not be effective unless they have real power.
Doug Naysmith: It is important to address the variations in standards of provision, but we must also recognise that CHCs also vary
Jos from Norwich: The proposal to abolish CHCs is rather different from what was contained in the Labour manifesto (which he read out)
Joan Penrose: The GLA health commission with Trevor Philips are looking into the Community Health Council issue.
David Spilsbury: Is against random selection for the Patients Forum, but accepts that there is variation in the standards of CHCs.
Donna (led a discussion on principles against which the proposals to replace CHCs should be based) which came up with this list, based on those agreed by the 4 nations meeting:
* Free at the point of use
* Perceptibly independent
* Accessible - geographically and culturally
* An integrated service
* Statutory rights
* An evolutionary improvement on existing systems
* Service wide
* Enabling for individuals
* People focussed
* Representative
* Locally responsive
* Transparent and accountable, particularly in the appointment process
* Properly resourced
* With a National body
Gavin Ross: Must be able to embrace the eccentricities of local leaders. Must have a continuing commitment.
Martin: There are problems with self-appointed community leaders such as the Patients Association. Could Scrutiny Committees be the employers of PALS and co-ordinate the Forums?
Trust employees will not have enough clout to be effective
CHCs could set up the new organisation
Workshop 2 Local democratic accountability
Workshop 3 Two sorts of accountability
Workshop 4 Delivering an effective service