Tuesday, July 11, 2006

11th Commandment. Thou shalt not neglect one's blog

Only when you are drowning in marking it isn't always something one looks forward to...still....

Dorothy is proving to be a sweetie albeit a very mischievous one - she seems to like eating fish most of all and a draw or cupboard cannot be open without her entering it. Think it will be time for her to start to explore the great outdoors before too long.

Some opinions, I think.

First, PPI Forums and their future. I have sat on our local Forum for the past 18 months or so. Its OK, a bit toothless, but does manage to ask some questions. I went to a meeting in Manchester which ... well, here's the report I have produced. Speaks for itself. Along with effective privatisation of the NHS it doesn't bode well.

The Future of PPI Forums – consultation held at City of Manchester Stadium, 4/7/06

This was one of a series of consultation meetings held both to inform PPI Forum members of the proposed changes to Forums given the future demise of CPPIH, and to gauge our views.

Conveniently, the Government had delayed the announcement of the changes to a time after most of the meetings had taken place, but given that the changes had been leaked to the press, there is reason to believe that the outlined changes are accurate

These are:
* Given the Government’s decision to abandon ‘arms-length’ bodies, CPPIH, despite its recent establishment, is no longer within boundaries of Government policy
* PPI Forums are likely to be abolished in June 2007 along with CPPIH. However, PALS and ICAS are to continue.
* PPI Forums are likely to be replaced with local ‘health involvement networks’ which will have input from local organisations as well as individuals, hence diluting the ‘patient’ element of PPI Forums. Membership details appear scanty and imprecise and questions such as whether membership would be static or fluid dependent upon the issues being discussed, or the relative rights and influence of individuals as opposed to organisations appear to be topics for further discussion. There appears to be a recognition that the skills and expertise of current forum members should not be lost but no precise plans as to how these are likely to be maintained
* No satisfactory distinguishing was made between the role of these new networks and the existing strategic role of the Health Overview and Scrutiny committees of local authorities
* Similarly, there appears to be no clear description of their powers and no indication that they will have statutory force
* It appears likely that Local Authorities may be given the funding responsibility but that arrangements will be made with the VCS who will support and service the networks. It appears likely that Networks will be coterminous with local authorities and will have far more explicit ties with them – again raising the question of the differentiation between these networks, and the overview and scrutiny function. There is also no clear intention for the future of PPI within the specialist functions eg mental health

The likely ‘spin’ placed on these proposals will emphasise the centrality of patient and public involvement to Government strategies, perhaps as part of their ‘localism’ theme which stresses the importance of local people and organisations championing local issues. A briefing paper is likely to be in the pipeline which will pull together some of the achievements made so far. Both the benefits of wider membership and greater allocated resources are expected to be part of the ‘spin’

There is awareness of the possibility of a ‘gap’ between the end of PPI Forums and the establishment of the new Networks but no firm proposals as to how this will be dealt with.

CPPIH are planning an event in October where Forum members will be able to meet and discuss the issues with their MP’s.

Perspective of Forum members present

There was a considerable amount of agreement expressed by the Forum members present at the meeting. Some of the key points are outlined below

* It is vital that PPI functions remain independent, particularly from the influence of local authorities, political parties and large, well-funded organisations.
* There was little enthusiasm for the presence of organisations within the new networks as it was felt strongly that they could all too easily be effectively colonised by professional paid staff representing large single-issue, sectional voluntary organisations, marginalizing individual and patient representation. It was felt that if there had to be organisational representation, this should consist entirely of unpaid volunteers and that representation should not be able to be done in paid work time, by paid professionals. The priority of community not sectional interest was emphasised, and it was suggested that group membership needed to be regularly rotated to avoid this danger.
* The current range of powers needed to be retained and strengthened – the proposals indicate that key powers such as that of inspection will no longer exist. This was strongly opposed.
* Concern was expressed over the lack of provision for specialist trusts, whose concerns and priorities are likely to be lost in a more generalist local network
* There needs to be an assurance of continuity between the planned closure of Forums and establishment of networks, without a ‘gap’ between the two.
* There was a recognition that networks would need to retain a high level of support, training, and so on, and that this could be assisted by a more formal, independent, national voice of PPI networks where sharing of good practice could take place.
* Finally, there was an awareness that reinvention of the wheel was NOT required and that it was important not to lose the skills and knowledge of members, although it was also recognised that many may not wish to remain involved given the nature of the proposals.

I am concerned that the proposals as they stand appear to be poorly thought out and conceived, and far from widening involvement, are likely to deliberately marginalize the involvement of the grass-roots patient voice, to the benefit of organisations. Should paid voluntary sector staff be allowed to sit on the new Networks, I would forecast that they will become largely professional-dominated and are likely to merge with the Overview and Scrutiny function of the local authority, given that they will hold the purse-strings and are unlikely to want to duplicate existing strategic scrutiny. In the process, the strength of forums – their ability to raise concerns about ground-level experiences of the NHS, will be lost

Any thoughts would be appreciated.

We seem to be in the curious situation where the Conservative party is sounding slightly more left wing than the Government. They are less enthusiastic about nuclear power. Cameron's speech about young people made sense - certainly more than anything stated by that jackbooted thug Reid. Ex CP of course, and doesn't it show. Authoritarianism at its worse, and when attached to the right-wing ideas of New Labour, guess what you get - right-wing populist Daily Excess style Toryism, only with a Glasgow accent.
Last Friday we went to hear Jane Kennedy speak about the NHS. She resigned from her post recently. Well, not exactly. Truth is Blair wanted to shift her to the defence ministry and she didn't fancy it - but I didn'tfind what she had to say of much inspiration. She appears to be opposed to some of the privatisation within the primary care sector but thats only a small part of whats going on - David asked a question about dentistry which she made no attempt to answer.

I voted Labour, for an MP who I don't like much, at the last election. I did so ONLY because I feared Howard. I don't fear Cameron in the same way. Next time the Boundary Commission has shifted us into a safe Labour seat - if the current MP is the candidate then I won't be voting Labour under any circumstances in any case, but at present they are giving me no positive reasons to do so.
Lets see - we are still in Iraq, still slavering at Bush's every word, still supporting renewal of Trident and nuclear power, still allowing private companies to run schools and hospitals, the list goes on.
If Tory policies are what we are going to get, maybe the Tories are the best people to implement them?

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