As part of the Health and Social Care Bill the Secretary of State (for the time being) announced the formation of… Healthwatch. Healthwatch is going to bring about, in Lansley’s words…
…real local democratic accountability and legitimacy to the NHS for the first time in 40 years.
Well, as someone who very much favours democracy, that sounded pretty damned good to me, so I have been watching and waiting these last 12 months or so for details of Healthwatch. Who will they be? How do you get to be a health watcher? What functions will health watchers have?
Sadly, the questions mount, but very few answers seem to have emerged. As far as I can gather Healthwatch will be a body commissioned by the local authority to carry out functions such as… acting as the consumer champion for the local community, and listening to the voice of local people, and it will be ‘representative’ of local people.
All of which sounds very nice, with lots of ‘local’ references, but what happened to the democratic bit… and how and to whom are they accountable? Who will appoint my local consumer champion? Will we have local ballots to determine who these people are, and meetings held in public where we will be able to challenge them? The answer I’m getting so far appears to be…. buggered if I know, councillor, but I very much doubt it!
Of course, as with so much of this ‘Big Society’ nonsense, what we are likely to be landed with is a self-selecting group of the unelected and unelectable acting as self-selected ‘people’s champions’. If they can fit it in somewhere in between sitting on the board of their own housing association, setting up their own ‘free schools’, running the local library and bidding to take over their local post office!
When it comes to democratic accountability I always think Tony Benn’s five tests of democracy are worth considering…
1. What power have you got?
2. Where did you get it from?
3. In whose interest do you exercise it?
4. To whom are you accountable?
(and most important of all)
5. How can we get rid of you?Only democracy gives us that right. That is why no-one in power likes democracy – and that is why every generation must struggle to win it and keep it.
So when Healthwatch comes to a town near you, do take the time to… ask them the five questions!
We in Wales have just had a Video sent to every household, and it says the NHS is changing for the better, which means we are going to cut, at the end it is confirmed because they say the NHS is being modernised which is without doubt cuts and more cuts.
I do not know Blair changed the NHS Cameron will change it, if labour gets back in they will do nothing to change it back and will change it.
In the end it will be something like the nice fee service they get in the good old USofA
Our Health Overview and Scrutiny Committee can give reasonably robust answers to nos 2-4 in Mr B’s tests and a sort of rather feeble one to no 5 but alas I think if it’s honest it can only answer “none worth speaking of” to no 1.
Apart from having excruciatingly dull meetings, its other major problem is that approx 99.98754% of the population apparently remains as unaware of its existence as they seemed to be of the Ambulance Patient and Public Involvement forum on which I briefly sat. The only merit of the latter as far as I could see was that it gave a few daft old farts like me somewhere warm to go now and then and it kept a few people employed in arranging meetings, taking notes, issuing largely ignored press releases, buying coffee and biscuits for us etc.
I guess a few consultants will be able to beef up their pension pots a bit by establishing Healthwatch but I won’t hold my breath about it doing anything for patients.
How very reassuring, Brian.
Once upon a time,there were Community Health Councils I suspect that they were scrapped because they asked a few awkward questions! A few years later Local Authority Health Scrutiny Panels came into being,they asked a few awkward questionsnow we have Healthwatch. Unless it behaves like a toothless Tiger, then they will be superceded by something else and the important questions will still not be answered!
I read your blog as I was looking for information about Healthwatch being put out to tender . It seems to me that the answer to your question of who is going to run this publically funded scrutinity body is whatever private campany gets the contract. Big well known companies are putting in tenders along with local groups and national charities-it is yet another service up for grabs in this free for all.
I have no democratic voice where I live as Labour gets very little support here. So I’m interested in what your council may be doing about organising who will be evaluating the Healthwatch bids in your area? It may depend on the amount of money in the contract as to whether you have to put it out to tender?
I suspect that they will not be a ‘self-selected’group of local individuals-they are more likely to be a large business self-serving its shareholders! Leaving out the ‘details’ about who can tender for Healthwatch was a stroke of genius- any big buisiness can join with a small ‘user voice’ under Sec 1 of the regulations. I am still trying to find out the details of Clause 2-they were still trying to decide on this, despite passing the Bill.
You will know, in your area, who in your Council is deciding on the evaluation of bids-unfortunately, the whole thing is so hedged around with EU Competition Law, that even when we want to ask questions, we are gagged. That’s one of the biggest threats to Democracy that people are unaware about.
I believe we must bring these issues to light in as many area as possible so would be very interested to receive your comments.
Rosemary, I think you are right. Of course, the LINk (predecessor to Healthwathch) also had outside support, but this seems to be more like a business approach. Difficult to know what is happening here locally – it alll seems to be an endless stream of consultation with no outcomes I’m afraid.