I went along to the so-called “People’s Launch” of Healthwatch this morning. This followed on from the presumably rather more select official launch of Healthwatch England that happened ten days ago. It took place about three floors underground with a couple of hundred local health activists packed into a low-ceilinged rather-too-small room to hear Norman Lamb MP, the (LibDem) Minister of State for Care Services, and Anna Bradley, the newly-appointed Chair of Healthwatch England, set out their vision of how Healthwatch will work.
What they said was positive and they are clearly keen for Healthwatch England (and, when they are formally established next Spring, for local Healthwatch organisations) to be effective in articulating the voices of the users of health and social care services.
The assiduous reader of this blog (you know who you are) will be aware that I have been critical of the way in which, during the passage of the Health and Social Care Bill through Parliament, the Government watered down the arrangements for Healthwatch and essentially facilitated the privatisation of patient representation and failed to ensure that Healthwatch England was genuinely independent.
Those battles were lost in the House of Lords, when – as always happened on key votes on the Health and Social Care Bill the LibDem peers voted en masse with their Conservative colleagues.
Two further big elephants remain in the room. The first is the extent to which local Healthwatch organisations will feel ownership of their national organisation, Healthwatch England. The regulations formalising the governance of Healthwatch England have yet to be confirmed by Parliament and they are being prayed against by the Opposition (the procedure that precipitates a debate and potentially a vote on a statutory instrument) later this month. Anna Bradley was keen to say (in response to my question) that it should not be a matter of ownership, either by local Healthwatch organisations in respect of the national body or vice versa. However, with Healthwatch England being formally a sub-committee of the Care Quality Commission it will remain the case that local Healthwatch organisations are going to feel that the national organisation is a top-down construct unless that have a substantial or majority stake in its governance.
The second elephant in the room is the budgets that will be available for local Healthwatch organisations. The money for these is being passed from the Department of the Health to the Department of Communities and Local Government who will then parcel it out to individual local authorities who are responsible for ensuring that local Healthwatch organisations exist in their areas. (Incidentally, these are the same local authorities which are responsible for the social care provision that local Healthwatch will be supposed to be monitoring – no potential conflict of interest there then.)
These monies are not going to be ring-fenced and there is no guarantee that all of the money provided will be made available for the local Healthwatch bodies (or even that it will be transparent as to how much was passed to the local council concerned). Norman Lamb (again in response to a question from me) lauded the principle of localism but was silent about how the Government would ensure that sufficient was passed on locally to deliver the high expectations that he had set in his earlier speech. He did, hower, report that he had increased the amount of money that is notionally being passed across to Eric Pickles’ Department for local Healthwatch. I asked him to look at the issue again …..