Big Changes in the Health Service

Friday was a day that took me deep into new territory. I had two meetings about the health service – not an area which I have really looked at before except in so far that I instinctively felt that everything I did to give people a better life through council services gave them better health as well.

In the morning I met with LGA colleagues including our own David Rogers the chair of the well being board and representatives of the six organisations that represent GPs. No I didn’t know there were six either and to be honest I still am not sure what they all do.

What I am sure of is that the idea being floated by some people that the commissioning role that is being given to GPs is privatisation. I am sure that somewhere in the many thousands of GPs there are some who are rubbing their hands at the thought of making money out of the change. None of them were represented by the six doctors round the table on Friday.

GPs understandably have some concerns about the changes. Change always brings uncertainty as well as opportunity and these changes will be the same. But GPs want to make the new structures work. They spoke enthusiastically about a new relationship with councils and clearly recognised that the ‘illness’ service that they represent could do far more to keep people healthy if they worked more with councils who have most of those proactive health functions.

Very shortly we will agree a public communiqué with them about how that will be achieved. We looked at the joint needs assessment and how it is compiled. This vital document will set a whole series of health and social care directions within localities. Instinctively the doctors understood the levels of governance at which we operate and we started to talk about how we can work alongside them at Needs Assessment; commissioning and surgery levels. WE all agreed that we can and should do much more together.

I was particularly pleased that one of the participants was a GP from Everton and I was able to describe our ‘coalition of the willing’ which we are building in North Liverpool to link up all public (and hopefully private) spending. This as a good example for all the doctors and one which he and I will follow up specifically in terms of the wider health deficiencies in his area. What is clear to me is that this has to be a partnership of equals. Some councillors are talking about health service being under our control. Some GPs are rightly expressing concern at this. I hope that we are able to reassure them that this will only work if there is mutual respect as we work together on an agreed programme of shared activity in the coming years.

In the afternoon I went to the first meeting of the Public Health Programme Board that has been established by the Department of Health to bring public health back into local government. I have written before about how most public health officials are pleased at this move back to what they regard as being their natural home. I am very pleased to be on this Board as a councillor from Liverpool. The concept of public health was invented in Liverpool more than 150 years ago when Doctor John Duncan was appointed as the Country’s first medical officer of health.

The poor were dying from a variety of wind and water borne diseases and horror of horrors the rich were dying as well. So the Council established a range of activities and programmes to deal with the problems for both. Naturally we commemorate this in an appropriate way. We have named a real ale pub after Dr Duncan and a fine pub it is too!

The Board will meet monthly until 2012 to ensure that the many problems entailed in the changeover with be dealt with. Chris Bull, the Chief Exec of Herefordshire Unitary and me as the local government representatives will ensure that the viewpoint of councillors and officials is strongly felt throughout the Department.

All the White Paper activity in this field fills me with hope that we can get better outputs for our money. I was staggered to hear from the GPs on Friday that the clinical outcomes and outputs we get for our money are amongst the worst in Western Europe. As someone said recently defending the Health Service is the nearest we get to a state religion in the UK. However it clearly is not working as well as it should and I am confident that the changes that the government is embarking on will lead to the population leading longer, healthier lives.

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About richardkemp

Leader of the Liberal Democrats in Liverpool. UK representative on UCLG Finance Committee, Executive Bureau and World Council. Deputy Chair and Lib Dem Spokesperon on the LGA Community Wellbeing Board. Married to the lovely Cllr Erica Kemp CBE with three children and three grandchildren.
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