Ray Collins on why the government should honour its commitment to allow Local Healthwatch bodies to campaign on patient issues
For Healthwatch to win public trust and become an effective organisation for patients, two things are necessary. Independence from the providers, commissioners and regulators of health services – because a patients complaint may involve the need to challenge any or all three of those interests. And also, genuine grassroots representation from groups and individuals – not top down organisation.
We have in Anna Bradley, the new Chair of Healthwatch England, a person with the commitment to try and make the national organisation work. The fact remains however, that it is a sub-committee of the Care Quality Commission (CQC) and it simply doesn’t have the power and authority of the three big players in the NHS – the Commissioning Board, the CQC itself and Monitor.
In the Local Healthwatch (LHW) regulations, this problem is mirrored locally. A potentially powerful mechanism, it is structurally weak because it relies on local authorities to fund who provides the social care that it is meant to monitor. But my real concern is that LHW, when it does eventually open its doors, will be bound and gagged by these regulations with its explicit ban on campaigning.
And this is all despite the commitment given by the Minister Baroness Northover at Lords Report stage of the Health and Social Care Bill, when she said:
“The noble Lord, Lord Warner, asked again about campaigning. I said in Committee that HealthWatch England and local healthwatch can campaign. I followed that up with a letter confirming that, which I hope he got-but perhaps he did not-and I reiterate it here. I hope that that is of help to the noble Lord.”
No one would condone a LHW campaigning against or for a political party. But these regulations go well beyond that, effectively banning LHW from leading campaigns to change poor services and amend legislation. Ministers will no doubt tell us that the words used in the regulations do not have the meaning I am placing on them. That in section 36 (2) of the regulations LHW will have the necessary freedom to undertake campaigning and policy work related to its core activities.
I am not alone in expressing concern on the actual words of the regulations. In their briefing on the Regulations, the newly established Healthwatch England stated that Section 36 (1a and 1b):
‘...should have been worded more appropriately to avoid any potential confusion, around the active role local Healthwatch will have in undertaking policy and campaigning work on behalf of consumers of health and social care services in their areas.’
They then go on to say:
‘Healthwatch England would welcome that these concerns be resolved in future statutory instruments. In the interim, Healthwatch England proposes that it works with the Department of Health and the Local Government Association to produce guidance for local Healthwatch and local authorities to assist them to correctly interpret the regulations.’
For once, it would be good to have regulations that mean what they say. Coming just before publication of the Francis Report on the disasters at Mid Staffordshire Hospital, Ministers in moving these Regulations are putting at risk the one pre-requisite that Healthwatch needs to do its job, ie have the trust of patients and the public. The current wording will undermine the effectiveness of LHW as the people’s watchdog in health and social care, and the government should now honour its previous commitments.
Lord Ray Collins of Highbury is a Shadow Health Minister, and also a member of the Shadow DfID team
Published 5th February 2013