Issue - meetings

This report provides an update on the Public Health strategy, Healthy Lives, Healthy People: our strategy for Public Health in England, and seeks approval for suggested consultation responses relating to funding and commissioning, and the Public Health Outcomes Framework.

RESOLVED: (i)         That the report and transition arrangements be noted.

                        (ii)        That it be noted that York will apply to be a pathfinder for Local Health Watch.

                        (iii)       That the amended responses to consultation set out in the annex to these minutes (set out below in the decision list), be approved.

REASON:      In order to provide an appropriate response to the consultation, taking into account the comments of the Health Scrutiny Committee and the need to ensure the provision of sufficient powers and funding to enable the new Health and Wellbeing Boards to provide increased democratic accountability within the Health Service.

Amended Draft Corporate response to: Healthy Lives, Healthy People: Our strategy for public health in England

A - Consultation Questions on Funding and Commissioning

Question 1: Is the health and wellbeing board the right place to bring together ring-fenced public health and other budgets?

Response:

Yes but this will need clear accountability and a shared understanding of responsibility for delivery. CYC welcome the clarity around separate and reinforced scrutiny of health and wellbeing across the whole system.

CYC believes that the Health and Wellbeing Board should contain substantial representation from local councillors to ensure that there is appropriate democratic accountability for any such Boards. The GP Commissioning Boards should have clear links to the HWB in terms of the development of Annual Plans and the monitoring of performance. There should not be an opportunity for other sectors in the Health Service to undermine the policies and decisions of the HWB.

The Health and Wellbeing Board will need to consider these external influences to maximise health gain.

Question 2: How can local authorities best be encouraged and supported to commission on an any willing provider/ competitive tender basis? How can securing a wide range of providers best be achieved?

Response:

Local Authorities already have systems in place to challenge service delivery on best value. Councils’ Financial Regulations encourage and require competition, where there is a market available. Councils will need to be able to ensure sufficient capacity within existing commissioning and procurement teams, and as part of this to maximise the opportunities for joint commissioning.

There needs to be a care to ensure that the prices offered are genuinely based on actual cost and not as loss-leaders to undercut NHS tariffs and to ensure that healthcare providers compete on the basis of measurable quality of care. There should be support, nationally or regionally, for local authorities to make sound judgements about the quality of provision, and in training for procurement officers to work in new fields of purchasing with which they may be unfamiliar.

Careful consideration needs to be made in terms of operating with the voluntary sector which needs support at this critical financial time, but which with encouragement can deliver a wide range of high quality services at efficient costs.

The silos between different parts of the NHS, Local Authorities, and private and voluntary providers need to be broken down as each has an impact on the  ...  view the full decision text for item 180

Members considered a report which provided an update on the Public Health strategy, entitled Healthy Lives, Healthy People: our strategy for Public Health, and sought approval for suggested responses to two consultation documents on the strategy.

Under the new system, Public Health England (PHE), which would be part of the Department of Health, would allocate ring-fenced budgets to upper tier and unitary local authorities to improve the health and well-being of residents.  The proposed division of functions between PHE and local authorities was set out in Annex 1 to the report.  On 5 October 2010, the Executive had agreed a response to consultation on the White Paper Liberating the NHS, welcoming the transfer of Public Health responsibilities to local government and local communities, subject to the transfer of adequate resources.  Many of the areas in the main strategy had been covered in that response, so the current consultation focused on Funding and Commissioning for Public Health and the Outcomes Framework for Public Health. 

The consultation documents had been discussed by the Health Overview and Scrutiny Committee on 24 January 2011 and their comments were attached at Annex 1A.  Suggested responses to the questions on Funding and Commissioning were set out in Annex 2, and suggested responses to questions on the Outcomes Framework were provided in Annex 3.  A revised version of Annex 3, detailing a response to question 7, and an additional annex (Annex 4), setting out suggested amendments to the response in the light of the Scrutiny Committee’s comments, had been circulated to Members before the meeting.  These have now been published with the agenda on the Council’s website.

The Executive agreed a number of amendments to the suggested responses at Annexes 2 and 3.  Having noted the comments of the Labour Group Spokespersons on this item, it was

RESOLVED: (i)         That the report and transition arrangements be noted.

                        (ii)        That it be noted that York will apply to be a pathfinder for Local Health Watch.

                        (iii)       That the amended responses to consultation set out in the annex to these minutes, be approved.¹

REASON:      In order to provide an appropriate response to the consultation, taking into account the comments of the Health Scrutiny Committee and the need to ensure the provision of sufficient powers and funding to enable the new Health and Wellbeing Boards to provide increased democratic accountability within the Health Service.