Today I was participating in a customer led transformation programme event held by LGiD in Birmingham on the theme of health. I’ve been amazed by the announced changes to the health sector of recent, not least by the pending sense of doom for PCT staff. On top of this there is a significant shake-up of adult social care in the form of the personalisation agenda.
The DOH have been working overtime on policy too. There are a number of white papers in the public domain such as “liberating the NHS” but one of the better, lesser know papers is entitled “role of local government in public wellbeing”. Yes, you might have guessed it – public health is coming back under local government control and it’s going to move by 2013.
While this probably isn’t news it may come as a revelation for some local authorities who will now be responsible for as many as 50,000 lost lives per year. Health staff will transfer to council and presumably there will be a series of new directorates such as ‘health and wellbeing’ which could consumer other departments such as leisure services.
The myriad of changes is quite overwhelming. I was lucky enough to have it explained by Liam Hughes from LGiD who took us through the nooks and crannies. If I could summarise all the plans it’s like breaking up the supermarkets and putting control into the power of corner shop holders. The good and bad attributes span from this premise.
Firstly there is a new ‘health watch’, think of it as the citizens’ advice bureau for health to replace Local Involvement Networks (LiNKS). This will have improved powers.
Then there are the GP commissioning consortia. GP’s are bright people, are great information guardians and they know how to run a small business. In principal, therefore, this is a good idea. However, they may not be best placed to deal with the problems of scale and sourcing business skills. The way that health services will be consumed is quite different and feels like the beginning of privatisation, akin to building a number of local private hospitals.
Next comes ‘public health England’. An all-in one which will absorb some of the roles currently carried out by quangos such as the HPA. Interestingly, however, this will work on a ‘payment by results’ basis.
Corporate social responsibility is in the mix too. The Public Health Responsibility Deal will see all the major private sector stakeholders take a role in tackling the growing set of health inequalities. It’s a sort of “you create, you pay” arrangement. While there is no official responsibility to play ball on behalf of retailers and the like, the threat of regulation looms. In-fact, it makes good commercial sense for such ‘bad health daemons’ to make good their offerings on the basis that it is self-perpetuating in terms of brand reputation.
It’s clear that new health and wellbeing boards will need more customer insight, fed from joint strategic needs assessment. Everybody in government needs to start thinking about health. We need to focus more on the causes of causes and we need to start doing all this yesterday.
I got a lot from the day, including a big idea for a policy modelling project. Got a job, anybody?