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The introduction of local government's health scrutiny powers in January marked a dramatic shift in the relationshi...
The introduction of local government's health scrutiny powers in January marked a dramatic shift in the relationship between health authorities and councils. That relationship has had its problems but there are signs of real progress. Scrutiny will provide an improved forum for strengthening the partnership working needed to tackle complex health problems.

A recent scrutiny training session, held in Birmingham and organised by the Health Development Agency and the Local Government Association, attracted 50 councillors from the West Midlands. For some, health scrutiny was new while others had made some good progress.

This experience mirrors findings of research carried out by the Improvement & Development Agency and the HDA.

Some councils have joint appointments with primary care trusts, share their budgets and undertake joint consultation - though this is often confined to health and social care.

There are those, such as Warwickshire CC, which have made health improvement an important part of their corporate strategy. In Kirklees MBC, the effectiveness of scrutiny was demonstrated when the health authority amended its plans for services for women and children after a council-led consultation exercise. A report based on local government improvement programme inspections is published on the IDeA's and the HAD's websites.

These signs are welcome, but there are still obstacles. The opportunities presented by the new powers would be lost if they were used simply to legitimise criticism and internecine quarrels between health and local government.

Councils must remember many of their services are critical to health. Reducing poor health and deprivation needs a coherent and intelligent approach. Looking at the needs of young people leaving care, the homeless or the elderly cannot be done in isolation. Councillors will need to work with the health sector and other partners.

PCTs, which have been given a clear direction to work in partnership to tackle health inequality and improve health, will need to recognise the very important role councillors play in community governance and the representation of local people, patients and user groups.

Scrutiny offers a real opportunity to tackle the health problems of a community in the way they can best be tackled - by partners working together.

The government's draft guidance and regulations for health scrutiny will be coming out for a final four week 'listening exercise' starting early this month and it is the ideal opportunity for councils to comment, and to consider how they are going to introduce effective scrutiny arrangements in consultation with their PCT. The final guidance and regulations are due out in early December for implementation on 1 January 2003.

The East Midlands HDA and the LGA are running seminars until the end of the year. Details from Rosi Pearce, email or tel 01664 502555.

Yve Buckland

Chair, Health Development Agency

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