The Minister listened!!

I have been a particularly ebullient critic of the Coalition Government's White Paper on Health in the last few months. (see earlier blog entries.)

Today the Government published its formal response document to the consultation process. I was involved directly, taking part in a Consultative session with Paul Burstow at the Liberal Democrats annual conference in Liverpool and in a private session with him later on, and I also helped to frame the official consultation response by Camden Council.

In the published response today Camden get a specific mention -

"Some respondents, for example Camden Council, wanted the Government to “require local authorities and health commissioners to pool resources”. Although we do not think this is practicable, we understand the sentiment. As Solihull Care Trust suggested, “local authorities will struggle to co-ordinate commissioning without a commitment from partners to joint/pooled budgets”. However, we agree with Suffolk and Great Yarmouth LPC when they say that “integrated working depends on the quality of local working relationships and although the Department can outline areas where integrated working is required this should not be too restrictive to prevent local innovation to occur”. This is backed up by the Lesbian and Gay Foundation’s suggestion that “lead commissioning and other flexibilities should be explicitly promoted and supported by the Department for the delivery of high quality community based specialist services”. Staff at Norfolk PCT echoed the views of many NHS respondents when they welcomed “the opportunity to increase dialogue between services and join services together for the good of patients”. The Bill will therefore place a duty on GP consortia and local authorities, through the health and wellbeing board, in drawing up the joint strategy, to consider how to make best use of the flexibilities they have at their disposal, such as pooled budgets. To reinforce this duty, the Department has also decided that the NHS Commissioning Board should be placed under a duty to promote the use of flexibilities by consortia. These duties do not require flexibilities to be used, but they signal the importance of maximising the use of the tools available.

And the views of Southampton City Council were identical to ours on the need for "compliance" of GP Consortia to follow the Joint Strategic Needs Assessment (or JSNA). The relevant sections in the response paper today are these -

"In the reformed system, the process and product of the joint strategic needs assessment takes on much greater importance. The health and wellbeing board will have a role in helping meet the need - expressed by the NHS Confederation and others - for GP consortia to have “access to public health expertise so that they can take a population health viewpoint, in particular access to epidemiological advice and insight into parts of the population that are either unregistered or invisible to general practice”, through for example the Director of Public Health being a member of the board. As Southampton City Council has suggested, the focus on the JSNA will help “ensure that GP consortia take commissioning decisions based on the overall needs of the population in future rather than the needs of their current set of patients”.

5.20 The Government fully agrees with the view of the Association of Directors of Adult Social Services that “all commissioning should be driven by the JSNA or shared assessments across local authority boundaries, whether these are GP commissioning, council commissioning or joint commissioning”. Many respondents, for example the Association of Directors of Public Health, Nottingham City Council, Oldham PCT, and Peterborough City Council, felt that the value of the JSNA could be enhanced by clearer expectations about its use within commissioning plans. The point is well made. At present JSNA obligations extend only to its production, not its application. To remedy this lacuna, the Government is therefore introducing in the Bill a new legal obligation on NHS and local authority commissioners to have regard to the JSNA in exercising their relevant commissioning functions.

Added to this was a commitment to strengthen the distinctive role of Scrutiny Committees, including the ability to scrutinise the decisions of GP Commissioners.

So we made some progress. And it's good to note that the Coalition actually listened to the responses and adjusted their approach accordingly.

JOHN BRYANT

Let's stage a World Premiership instead!

The huge disappointment of England not being chosen as the 2018 host for the World Cup has led on to some angry criticism of FIFA and it's internal workings. Corruption of officials appears to have been fully uncovered by the Sunday Times and BBC's Panorama programme.

However the argument that investigative journalism should be restrained out of patriotic interest is in itself suspect. If we had won the nomination through a corrupt process, then how could we then be proud of the outcome? England offering a friendly against Thailand in exchange for a vote is as corrupt in my book as a brown envelope stuffed with cash to a FIFA representative.

The exhaustive ballot process is also inefficient and suspect. I noticed that in the vote for the 2022 tournament Qatar actually lost a vote between two stages. Use of the Alternative Vote would stop all attempts of later stage tactical voting, as the losing country's votes would automatically transfer to later pre-registered preferences.

Given the total lack of confidence many nations (at least of a democratic variety) now have in FIFA, it is time for English football to replicate its own previous rebellion when the leading clubs rebelled against the Football League and set up their own tournament.

Surely it is time the English FA formed a World Premiership tournament to take place in England during one summer when the Olympics and World Cup will not be taking place - perhaps in 2013? We already have the stadiums and training facilities to stage a tournament. It could be by invitation only to the world's top 16 footballing nations, taking account of the most recent regional tournaments such as the African Cup of Nations, Euro 2012 and the South American and Asian equivalents.

For some countries it might prove to be a useful trial run for the Brazil World Cup in 2014, but it might find its own momentum as a genuine alternative to FIFA's suspect package. After all we had significant splintering of the world titles in boxing some years ago and so the precedent is set for staging an alternative to the "official" tournament.

If FIFA threaten to exclude the top nations who choose to take part in the World Premiership then the top nations should walk. The TV companies know where the money will be and they will choose to show the best football they can to their subscribers.

So does anyone in the English FA have the guts to lead on this?

Who is ready for a public meeting?

It was curious to note that although we had around 80 residents who turned up on a cold night for the Area Forum in West Hampstead on Monday hardly anyone had been attracted to come by reading about the event on Twitter or Facebook. While most of our citizens are using e-mail these days there still seems to be a generation gap between those who are attracted to attend a traditional public meeting to keep up to date with current affairs, and those who aren't. The latter appear to be under-45, and are ready to post their opinions on social networking sites, but won't push through the doors of a community hall of an evening.

The same generation gap is sadly affecting the active membership of traditional residents and amenity groups too. I attend a fair number of community meetings as a councillor but I know there is a significant demographic I rarely come across. Within the boundaries of West Hampstead ward we have a higher than average number of people in the 25-34 age group compared to the population as a whole, but these are precisely the people we don't see taking part in community groups.

Many will be transient because of their work, so do not settle in the area, and therefore take less interest in local affairs. Those who put down their roots by buying a property or by having permanent tenancies are those who tend to join in. The only exceptions to my thesis are those who have children of primary school age and get involved in the local schools as Parent Governors or members of Friends Groups. But I suspect these are also the "settlers", and given the trend to have children later in life, many of these will be approaching 40 before they get stuck in to organising the school tombola or joining the Governors' Finance Committee.

I am not sure whether I should be worried or not. We have gone twenty years or so since a younger generation was catching the headlines with direct action with demonstrations and sit-ins. More recently the demonstration against the Iraq war also caught the imagination although this was across all age groups.

The recent unrest about student tuition fees, although in my view largely misplaced (See my earlier blog) at least shows us that when the right cause comes along the young can still get worked up about it. They are the ones who do use the social networking sites to organise their activities, but it tends not to be an invite to a public meeting in a draughty hall...