Issue - items at meetings - Public Questions

No public questions have been received

85.1    There were none.

No public questions have been received

72.1    There were none.

No public questions have been received

57.1    There were none.

No public questions have been received

43.1    There were none.

No public questions have been received

30.1    There were none

No public questions have been received

19.1    There were none.

No public questions have been received

4.1       There were none.

No public questions have been received

65.1    There were none.

No public questions have been received

50.1    There were none.

No public questions have been received

36.1    There were none.

A public question has been received:

"Does the committee agree that the government's plans for the NHS in its recent white paper, involve such a degree of reorganisation that it should be implemented only once adequate consultation with the medical profession and the wider public has taken place, and only when the policy has been proved effective by pilot schemes. Further, the timing of this policy, involving massive transitional costs when the government is planning extensive cuts in public spending, is ill advised."

Mr Ken Kirk

21.1    A question was submitted by Mr Ken Kirk.

21.2    Members discussed whether the question submitted was an appropriate one for HOSC, and agreed that it would be better answered at Full Council, where members were free to address ‘political’ issues.

21.3    Mr Kirk agreed to present his question to the next Full Council meeting.

None have been received to date

4.1       There were none.

None have been received to date

66.1    There were none.

No public questions have been received

47.1    There were none.

None have been received

31.1    There were none.

The closing date for Public Questions is noon on 22 September 2009.

18.1    There were none.

A Public Question has been received for this meeting. It is:

“Recent developments in the local health service have shown that the PCTs are being asked to consider non-NHS providers when contracts are allocated. Does the committee agree that, as with the government’s recommended procedure, it is vital that the public’s views are sought, and would the committee therefore write to all PCTs to ask that a proper public consultation is carried out, to include requesting submissions from Brighton and Hove residents, and the holding of a public meeting, before the allocation of the contract?”

Ken Kirk

4.1       A Public Question was asked on behalf of Mr Ken Kirk, and the committee debated the issues raised.

4.2       A member argued that requiring Primary Care Trusts to launch a full public consultation exercise every time they put a service out to tender would be disproportionate, particularly given the fact that corporate involvement in the local health economy was relatively minor and did not appear to be growing.

4.3       Another member agreed that full public consultation might not be appropriate in many instances, but argued that the Primary Care Trust could still make some effort to involve the public in these issues, perhaps by allowing people to email their views on particular services. For significant contracts, full public engagement was essential.

4.4       The Chief Executive of NHS Brighton & Hove told members that the PCT was committed to public engagement whenever appropriate, but that the technical and/or confidential nature of aspects of tender processes might preclude full public involvement in some instances.

4.5       The Chairman noted that one of the major roles of the committee was to ensure that local Primary Care Trusts consulted appropriately. It was the committee’s view that NHS Brighton & Hove did generally follow best practice in terms of public involvement in its work, and he was therefore not minded to accede to the questioner’s request to write to local Primary Care Trusts urging them to consult more broadly.

No public questions have been received.

86.1    No public questions had been submitted to this meeting. However, the Chairman chose to take the scheduled item on chiropody services here, as it had originated with a public question asked at the previous HOSC meeting.

86.2    Darren Grayson, Chief Executive of NHS Brighton & Hove (the Primary Care Trust – PCT), and Wendy Young, who commissions foot care services for the PCT, answered members’ questions on this subject.

86.3    Jack Hazelgrove, of the Older People’s Council, noted that there was a considerable disparity between the importance of general, preventative foot care services and the actual reach of city services, with many older people paying for private treatment rather than using publicly funded services.

86.4    Members were informed that basic foot care services are not officially categorised as healthcare and the local NHS is therefore not liable to provide them free at the point of delivery. However, NHS Brighton & Hove (NHSBH) recognises the importance of preventative foot care and consequently commissions Age Concern to provide some preventative care. The council’s Adult Social Care (ASC) department also funds some general foot care services (ASC and NHSBH neither jointly commission nor fund this provision).

86.5    In answer to a question about providing foot care services from GP surgeries, members were told that services are currently available in two city GP practices (in Portslade and East Brighton). However, GP practices charge for the use of their facilities, which may mean that more widespread provision is not practicable. Age Concern does currently offer domiciliary visits for patients unable to travel to access foot care services.

86.6    The Chairman noted that this was an important subject and one the committee should revisit at a later date.

Two public questions were submitted for this meeting.

73.A    (submitted by Ken Kirk):

“We already know that the B&H PCT (Primary Care Trust) didn't conduct a proper public consultation over the setting up of a GP Clinic, contravening the Department of Health's PCT Procurement Plan. The PCT has given the contract for it to Care UK who run the SOTC (Sussex Orthopaedic Treatment Centre). It was revealed at the November HOSC that the SOTC selects the cheaper surgical procedures, leaving the BSUHT (Brighton & Sussex University Hospitals Trust) to fund the expensive ones. At the meeting a senior clinician stated the hospital has a £2 - £3 million deficit as a result. On whose behalf does B&H PCT spend our NHS funds? Would the committee investigate the awarding of this contract?”

73.B    (submitted by Jack Hazelgrove, Older People’s Council):

“Owing to the limited availability of chiropody services on the NHS, many older people are paying privately (often around £25) for treatment. Could NHS Brighton & Hove outline the current arrangements for provision of this service and any plans to increase the availability of treatment for older people. Could NHS Brighton & Hove also explain the criteria for ‘rationing’ the service and indicate any system of prioritisation for certain ‘at risk’ groups (e.g. diabetics).”

73A     Public Question from Mr Ken Kirk

73.1    Mr Kirk asked the following question:

“We already know that the B&H PCT (Primary Care Trust) didn't conduct a proper public consultation over the setting up of a GP Clinic, contravening the Department of Health's PCT Procurement Plan. The PCT has given the contract for it to Care UK who run the SOTC (Sussex Orthopaedic Treatment Centre). It was revealed at the November HOSC that the SOTC selects the cheaper surgical procedures, leaving the BSUHT (Brighton & Sussex University Hospitals Trust) to fund the expensive ones. At the meeting a senior clinician stated the hospital has a £2 - £3 million deficit as a result. On whose behalf does B&H PCT spend our NHS funds? Would the committee investigate the awarding of this contract?”

73.2    Members discussed this question and determined that it would be desirous to set up an ad hoc scrutiny panel to investigate the process by which a contract for the Brighton & Hove GP-Led Health Centre had been awarded.

73.3    Councillors Alford, Allen and Kitcat agreed to sit on the ad hoc panel; Councillor Allen agreeing to sit with the proviso that the panel should take the absolute minimum time required to examine the matter properly.

73.4    Mr Kirk then asked a supplementary question in which he suggested that it might be good practice for NHS Brighton & Hove to conduct a regular audit of the GP-Led Health Centre and adjoining GP practices in order to measure whether the GP-Led Health Centre was having a negative impact upon other surgeries in the area.

73.5    The Chairman told Mr Kirk that this idea would be considered by the ad hoc panel, and thanked Mr Kirk for his question.

73.6    Darren Grayson, Chief Executive of NHS Brighton & Hove, told members that he welcomed a review of the GP-Led Health Centre. Mr Grayson informed the committee that the GP-Led Health Centre initiative was Government policy and that Primary Care Trusts were bound to commission health centres in line with this policy.

73.7    In response to a comment from a member suggesting that there should have been public consultation on the location of the Brighton & Hove health centre, Mr Grayson informed members that NHS Brighton & Hove had consulted on the location and had presented the results of this consultation to a previous Health Overview & Scrutiny Committee (HOSC) meeting. Mr Grayson told the committee that the development of the GP-Led Health Centre should be welcomed as it would provide a valuable addition to the city’s primary care facilities.

73B     Public Question from Mr Jack Hazelgrove (Older People’s Council)

73.8    Mr Hazelgrove asked the following question:

“Owing to the limited availability of chiropody services on the NHS, many older people are paying privately (often around £25) for treatment. Could NHS Brighton & Hove outline the current arrangements for provision of this service and any plans to increase the availability of treatment for older people. Could NHS Brighton & Hove also explain the criteria for ‘rationing’ the service and indicate any system of prioritisation for certain ‘at risk’ groups (e.g. diabetics).”

73.9    The Chairman thanked Mr Hazelgrove for his question. As the question sought fairly complex information, the Chairman had decided that she would not seek an answer at this meeting, but rather would ask NHS Brighton & Hove to provide a full written answer for the next scheduled committee meeting.