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1. Purpose of report

1.1. To agree a consultation paper setting out how the County Council proposes to use its power of health scrutiny.

1.2. To agree arrangements for consultation with, in particular, NHS and unitary and district council partners on those proposals.

1.3. To recommend to the Cabinet that a new County Council Policy Review Committee be set up to exercise the Council's power of health scrutiny and that in preparing the County Council's budget 2003-04 the Cabinet considers provision necessary for health review and scrutiny.

2. Background

2.1. The County Council's Cabinet asked this Policy Review Committee to develop proposals for the arrangements the County Council should make to introduce health scrutiny. A seminar for partner organisations was held at Sparsholt College in June. An informal Member meeting on 16 September, to which all Members of the County Council were invited, gave detailed consideration to issues about how health scrutiny should be approached and the arrangements that should be proposed. The draft consultation document reflects the consensus of views from that discussion.

3. A Health Review Committee

3.1. It is an informal conclusion from earlier consideration by the Committee and discussion at the Member meeting on 16 September that health scrutiny is of such significance that it should be the responsibility of a committee set up with that single purpose. When the Cabinet asked this Policy Review Committee to develop proposals, it had been implicit that health scrutiny would be added as an additional function to the terms of reference of an existing Policy Review Committee - and Policy and Resources PRC was the most appropriate.

3.2. Health review and scrutiny will involve extensive committee consideration and Member time. It is a matter of significance and importance to the County Council and will be of considerable public interest and concern. It gives the `wrong messages' for it to be added to the agenda of a PRC with other important terms of reference. Furthermore, it would be likely to overburden the Members of that committee. And a separate, new committee gives the County Council the opportunity to bring in a wider range of expertise from Members with interest and knowledge in related issues such as education, environment and transport/accessibility.

3.3. It is recommended that the Committee formalises its view and recommends the Cabinet (28 October) that it recommends the County Council at its meeting on 28 November to set up a Health Review Committee with terms of reference to develop arrangements for exercising the County Council's power of health overview and scrutiny and for establishing relationships and liaison with the County Council's NHS partner organisations.

4. The Consultation Paper

4.1. A draft consultation paper is attached for agreement by the Committee. It was the view of the informal meeting that the consultation paper should invite comment on the arrangements the County Council is proposing rather than seek views on the principles and purpose of scrutiny (which is a matter determined by Government, and set out in the Department of Health consultation paper and to be confirmed in the draft guidance).

5. Arrangements for consultation

5.1. It has been the Committee's intention to focus consultation on partner organisations in the NHS, organisations representing patients and health service users and partner local authorities - the unitary councils and the Hampshire district councils.

5.2. It is proposed that copies of the consultation paper be sent to all partner organisations by the end of October with a covering letter offering face-to-face discussion. In the case of the Primary Care Trusts (PCTs), the Member who attends executive meetings as an observer, together with the County Council's Partnership Manager, will be able to present the consultation paper at an appropriate Executive or Board meeting.

5.3. For other NHS bodies, Community Health Councils (CHCs), Patient Forums, unitary and district councils, arrangements will have to be made to respond to requests for a meeting. The Chief Executive will discuss with the Chairman when such requests are received whether Member or officer attendance should, and can, be offered and arranged.

5.4. It is not proposed that arrangements be made for consultation with the general public other than publicising that a copy of the consultation paper is available on the County Council's website.

5.5. The draft proposes an end date for receipt of representations of 31 December, so comments and representations can be analysed and could, subject to the decision of the County Council, be considered as a first meeting of a new Health Review Committee in January 2003.

6. Making financial provision for health reviews

6.1. The draft consultation paper points out that health scrutiny is a power, not a duty, and that the Government has not so far issued any statement about how it should be funded.

6.2. The informal Member meeting was of the general view that health scrutiny was an area of considerable public interest and the Government's proposals that local authorities should provide the mechanism to achieve community accountability of NHS services was a significant recognition of local councils' authority and legitimacy to represent the interests and views of the communities that elect them. Members considered it would be imprudent to fail to take steps to exercise the power of health scrutiny.

6.3. It is to be hoped that the Government will give some indication of additional funding when draft guidance is issued. It is the Government's intention that community health councils should be abolished from end of March 2003. Part of the functions of CHCs has transferred to Patients Forums and the Patient Advisory and Liaison Service. Part is transferring to local authorities with social services responsibilities. It would be equitable for funding also to transfer to these authorities to part-fund the role of health overview and scrutiny.

6.4. The Committee is recommended to recommend the Cabinet to consider health scrutiny when preparing the County Council's budget for 2003-04. There was discussion at the informal Member meeting of the financial consequences of undertaking health reviews and scrutiny. If a new Review Committee is set up there would be consequences for committee administration. Professional advisers would be needed to manage and guide individual reviews. The proposed style of working - hearings, visits, commissioned research - would also need appropriate funding. The draft consultation paper indicates that the County Council will decide the extent to which it exercises its power of health overview and scrutiny in the light of announcements about Government funding. It is provisionally estimated that the full-year costs of arrangements outlined in this paragraph would be £150,000-£200,000. But both procedural arrangements and the programme of health reviews could be adapted to `fit' with larger or smaller budget provision.

6.5. If the County Council agrees to set up a Health Review Committee, its first, possibly informal, meeting could be in January when it could consider representations received on the consultation paper and, in the light of Regulations, Government guidance and Department of Health announcements on funding, decide an appropriate approach to health scrutiny and reviews. Those decisions would need to be matched by the Cabinet including appropriate financial provision in the budget it recommends to the County Council.

Recommendations

1. It is recommended that:

1.1. the draft consultation paper be agreed for distribution to partner organisations and be made available to the public on the County Council's website

1.2. the Committee endorses the proposal for the setting up of a new County Council committee specifically for the purpose of undertaking health overview and scrutiny and recommends the Cabinet accordingly

1.3. the Committee recommends the Cabinet to consider health scrutiny when preparing the Council's budget for 2003-04 : the Committee considers that it would be imprudent for the County Council not to make arrangements to exercise the power of health scrutiny and that detailed arrangements, including a programme of reviews, should be determined when the Government's decision on funding is known.

Section 100 D - Local Government Act 1972 - background papers

The following documents disclose facts or matters on which this report, or an important part of it, is based and has been relied upon to a material extent in the preparation of this report.

NB the list excludes:

1. Published works

2. Documents which disclose exempt or confidential information as defined in the Act.

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