The LGA and Solace have issued strong objections to government plans to change councils’ health scrutiny role, claiming the measures could politicise the process, cause “unacceptable delays” and create conflicts of interest.
Under the proposals from the Department of Health, decisions to oppose NHS reorganisations - such as hospital closures – would have to be taken by full council meetings, rather than health scrutiny committees.
Councils would also have to refer the reorganisation plans to the NHS Commissioning Board, rather than directly to the DH, in some cases.
The two umbrella bodies have raised a series of objections to the plans. “Dictating that full council must make referral decisions flies in the face of local decision making and would result in unacceptable delays, adding bureaucracy to the process rather than reducing it,” a statement from Solace said.
“Proposals to refer some service reconfiguration decisions to the NHS Commissioning Board, rather than directly to the secretary of state, could create conflicts of interest, not least because the commissioning board may be involved in the initial development of the proposals now being contested,” the statement said.
The groups have raised their concerns in a joint response to a consultation on the plans. In the document they argue that requiring full council agreement “could potentially politicise matters” because “scrutiny function is neutral in contrast to full council.”
The document says: “It should be for local authorities to determine which committee they delegate referrals to, based on the local constitution.”
It also warns that executive members are on health and wellbeing boards, which can make commissioning decisions and are involved in “service reconfiguration decisions” by clinical commissioning groups. “If these members were involved in early discussions and decisions about a service reconfiguration that is being considered for referral to the secretary of state, there would be a high risk that they would be unable to be completely objective in scrutinising it later,” it says.
The consultation also asks whether central guidance should set out timescales for the process of objecting to reorganisation plans. The response from Solace and the LGA says: “No. This would be too prescriptive. Local schemes differ in nature and complexity and so timescales should be locally determined.”
The document also airs frustrations about the relationship between councils and the health service in previous cases. “Too often in the past, health proposals have, for whatever reason, not been fully aired in advance, leaving both executive and scrutiny members in a difficult position without a reasonable business case for reconfiguration and, therefore, unable to articulate and represent the rationale.”
It says “early, trusting, discussions should be taking place across the system.”
The DH consultation on the plans closes today.