Key Facts

• Richard Murray, chief executive of the King’s Fund, discusses risks and benefits of proceeding with the Bill.
• Nick Timmins agrees that stopping the progress would be worse than continuing with the current direction.
• Nigel Edwards concurs with previous statements without adding new insights.
• Steve McCabe apologises for moving on to the next speaker.
• There are about seven minutes left for Back Benchers to speak.
• The current reconfiguration system involves four tests set up by Andrew Lansley.
• The Secretary of State has a say in controversial decisions but is not involved in every minor change.
• The Independent Reconfiguration Panel has handled about 80 controversial cases and its advice is almost always followed by the Secretary of State.
• Competition in healthcare has not been effective due to shortages and lack of meaningful choice.
• Patient choice in diagnostics, maternity, and elective surgery can have beneficial effects on provider behaviour.
• Tariffs that pay based on activity can create perverse incentives discouraging community-based services.
• The Bill aims to formalise ongoing activities related to integrated care rather than setting a new policy direction.
• Richard Murray highlights the poor track record in planning the health and social care workforce as a critical deficiency in the Bill.
• Nick Timmins emphasises that tackling the workforce issue is crucial but notes that much of the current drive towards better integration will not come through legislation beyond what is already in the Bill.
• Experts expressed concerns about new powers of direction and reconfiguration service changes.
• The legislation aims to be both evolutionary and permissive rather than prescriptive.
• There are reservations about building in reconfiguration service changes.
• Steve McCabe chairs a session with Dame Gill Morgan and Louise Patten.
• Dame Gill Morgan is chair-designate of Gloucestershire ICS and advisorate for NHS Confederation’s ICS network.
• Louise Patten heads up the ICS network and NHS clinical commissioners at the NHS Confederation.
• Clinical representation is fundamental in each of the three areas of ICS: improving current health services, creating healthier populations over time, and transforming existing services to be more community-orientated.
• Primary care sub-committees are established to maintain focus on primary care issues without being subsumed by generalist groups.
• Multi-layering of advice is necessary for effective governance in ICSs.
• The Bill takes a permissive approach rather than a prescriptive one.
• Concerns are raised about the Secretary of State's power to call in changes after consultations.
• Witnesses recommend setting a core membership for ICBs but allowing flexibility to expand based on local needs.
• Dame Gill Morgan argues for clarity in guidance rather than rigid legislation.
• Partnership approaches have been effective in handling finance and quality issues.
• Sub-groups like accounts, audit, remuneration are required by statute.
• Collaboration is essential to address long-term agendas effectively.
• Steve McCabe introduces Ed Hammond from the Centre for Governance and Scrutiny.
• Andy Bell is introduced as deputy chief executive at the Centre for Mental Health.
• James Davies asks Andy Bell about how the legislation can address current health inequalities.
• Andy Bell highlights the importance of external scrutiny in mental health.
• The Care Quality Commission currently lacks powers to scrutinise systemic fairness across all groups of people.
• Legislation could place specific duties on NHS England and ICBs to ensure equal regard for mental and physical health.
• Steve McCabe is discussing the role of local authorities in larger Integrated Care Systems (ICSs).
• He emphasizes the need for a balance between regional decision-making and localized knowledge.
• The statement highlights concerns about losing place-level emphasis in large ICSs.
• There has been underinvestment in preventative public mental health.
• The Office for Health Improvement and Disparities is an opportunity to elevate public mental health.
• Funding was given to local authorities in the 40 most deprived areas through the promotion and prevention fund.
• The NHS has ambitious plans for mental health as part of its long-term strategy.
• There is a significant gap in meeting people's mental health needs.
• Collaboration between the NHS, local government, voluntary sector, and community services is crucial.
• Provider collaboratives have shown success in reducing out-of-area hospital admissions for children in mental health crises.
• The Health and Care Bill involves restructuring decision-making processes in healthcare.
• Local councillors with powers through health scrutiny committees are crucial for accountability.
• Concerns about local needs being overshadowed by national priorities.
• Steve McCabe facilitates questions to Sir Robert Francis regarding the Health and Care Bill.
• The statement discusses the importance of patient choice and involvement in healthcare service design.
• There is a focus on the role of Healthwatch representatives in providing feedback and intelligence on public concerns.
• Steve McCabe addresses concerns about the Health Services Safety Investigations Body's safe space provisions.
• He discusses the need for discretion in sharing information with bereaved families.
• The discussion revolves around balancing the protection of whistleblowers with the need for transparency towards patients' families.
• The current legislation lacks clarity on what happens when an integrated care board (ICB) disagrees with an integrated care partnership’s (ICP) plan.
• There is a suggestion to insert provisions into the Health and Care Bill requiring ICBs to provide reasons if they set aside the ICP's plan.
• Qualitative data, such as comments from friends and family tests, should be recognized and shared with statutory bodies like Healthwatch for better service evaluations.
• Stephen Chandler is president of the Association of Directors of Adult Social Services (ADASS).
• Gerry Nosowska is chair of the British Association of Social Workers.
• ADASS represents directors in adult services across the UK.
• Stephen Chandler is working with his CCG colleagues on the Better Care Fund agreement signed at the beginning of the year.
• Oxfordshire County Council has responsibility for over £500 million in health and social care expenditure.
• The 'Home First' principle clarifies that discharge should ideally be to a patient's home with appropriate support.
• Carers play a crucial role in supporting individuals post-discharge.
• The health and care system would disintegrate rapidly without carer support.
• Stephen Chandler believes the Bill will improve integration in health and social care.
• Concerns have been raised about the potential weakening of the role of social workers during transitions.
• The Department of Health and Social Care has undertaken a review of discharge to assess arrangements for eight separate systems.
• The Bill formalises the requirement to plan carefully for population needs at a place level before system level.
• It sets up an integrated care partnership with clear objectives based on the population.
• Some ICSs have different population groups, making collaboration more complex.
• The Committee will meet again on Tuesday 14 September at 9:25 in Committee Room 14 with Mr Peter Bone in the Chair.