Welsh Conservatives Debate: Community Health Councils
Plenary Wednesday 20 September 201717:22
Gareth Bennett AM
Party: United Kingdom Independence Party (UKIP)
Spoken Contribution – 17:22:53
Watch this contribution on Senedd TV | View this contribution in the Record of Proceeding document
Thanks to the Conservatives for bringing today’s debate forward on an important subject. We’ve heard a lot already about the flaws in the Welsh Government’s consultation process, so I won’t dwell on that, but rather on the changes that they propose in their White Paper.
Now, ‘Services fit for the future’, the White Paper, recognises the need for what it calls a strong citizen voice in how health and social care is planned and provided. They also want to improve the legal framework for the inspection and regulation of health services and they want to establish a new independent body for patient voice and regulation and inspection.
Unfortunately, this so-called citizen voice is not described in any detail in the White Paper. There is nothing about how the members will be recruited. There is nothing about resourcing of the new organisation. The only thing we can see clearly is that citizen voice is designed to replace the existing system built around community health councils, or CHCs.
The White Paper uses the current buzz phrase of co-production. However, it doesn’t really go into much detail regarding what this so-called co-production will actually consist of. If we go back to the Welsh Government’s own social services Act of 2014, the codes of practice in this Act do actually give us detailed guidance as to how to achieve co-produced well-being. This includes promoting user-led organisations that add social value. Well, the CHCs with their membership containing a strong element of volunteers surely represent a good example of a user-led organisation. The notion of co-production should surely be encompassing bodies like the CHCs, rather than being used as a vague form of words that is utilised to help get rid of them.
So, why does the Welsh Government want to ditch the CHCs? Well, Co-operatives and Mutuals Wales, an important third sector organisation, believe that the Welsh Government has a problem with the extent to which the health boards propose sometimes substantial changes, which are then challenged by the CHCs. Although the proposed Government changes are somewhat vague, it is widely believed that under the new system the new body would crucially lose many of the powers of the CHCs. It is not clear if the new organisation would have any rights at health board meetings, for instance. It is also widely suspected that it would not have the power enjoyed by the CHCs, which we’ve been told about today, to enter and inspect premises for spot checks. These powers are crucial in gaining an understanding of how the NHS actually works in one local area. Any new body, if it is to have a meaningful role, must be allowed to visit and inspect NHS premises, speak to patients there, and afterwards be able to contact the patients and former patients once again in order to help establish whether improvements have been made as a result of that body’s intervention.
We need to remember that the model of community health councils scrutinising the work of the NHS came in after the Ely Hospital scandal in Cardiff in the early 1970s. The system adopted throughout the UK at that time came about after a scandal, in other words, which afflicted our own local area. If we are to avoid future scandals—and let’s not forget we’re still in the throes of recovering from the Tawel Fan scandal—then we need to stick to certain clear principles of operation and scrutiny.
Decisions should be taken as close to the people who use the services as possible. Local priorities should be established according to local needs. There should be clear lines of accountability, and volunteers need to be the lifeblood of the scrutiny organisation. Volunteers will have different skills and contribute in different ways. Any new body must be free to determine how it recruits its own volunteers. We are left entirely in the dark from the Welsh Government’s White Paper as to how far these principles are going to be upheld in the new model. We, therefore, in UKIP support the Conservative motion today and urge the Welsh Government to consult further, and more openly, before adopting any new model. We also support Plaid Cymru’s amendment.
A worrying aspect of devolution is that we now have four separate models of user scrutiny of the NHS in the four different regions of the UK. Although enthusiasts for devolution might argue that this is a welcome expression of different regions going their own way, I would argue to the contrary that we have a national health service, not a regional one, and that it should operate broadly in the same way across the UK. The way in which patients are treated and the way in which users can scrutinise the work of the NHS should not differ markedly across the different regions, or we will gradually lose any sense of it being a national service at all. Thank you.