Last update 15th. May 2004
IT'S 13 months since Lord Hunt of Kings Heath resigned as junior health minister over Iraq, citing his "two-year battle to get rid of community health councils (CHCs)" as one of his greater achievements.
He was convinced a "big bang reform" was needed and trumpeted the creation of new patient involvement forums (PIFs). But his promise that CHCs wouldn't go until the forums were fully functional has proved an absurd miscalculation. CHCs in England were shut down last December; but the £39m ploughed into the Commission for Patient and Public Involvement in Health (CPPIH) in its first year to oversee the setting up of the new forums has achieved, according to one insider, "nothing but the barest structure".
A senior source at the department of health recently registered dismay at how little the CPPIH has delivered for its money. According to commission chair Sharon Grant, its role is "to give the patient forums the tools and information they need" and "to make proper arrangements for the forums to do their jobs properly".
Alas, a recent survey by the Health Service Journal (8 April) found that many forums are "struggling to survive due to lack of resources and poor administrative support". Even worse, "forums are hidden from the public they were set up to serve because the CPPIH and its forum support organisations (sic) have refused to make membership lists public". And most forums were so desperate for members that the only selection criteria was "if you turn up, you're in".
The DoH is so worried about the performance of forums it has delayed plans to give them responsibility for the Independent Complaints Advisory Service; and there is little evidence of 575 forums in England achieving their statutory duty to monitor NHS trusts on behalf of patients. As with the Patient Advocacy Liaison Services, there is a real worry that forums can't achieve independence when they are so closely aligned to the trusts they are supposed to monitor.
As one Eye reader and forum member puts it: "We have been subject to a flood of verbiage from the commission: welcome day notes, minutes, consultations, guidance, diversity surveys, `Take time for Health'... [But] we cannot visit anywhere in our official capacity as we still do not have our identity cards. The commission and support organisation appears to be run by second-rate civil servants who are perforce making it up as they go along.
"Our forum is a group of excellent people but we have achieved nothing. It is possible that we might come up with some idea for improvement, champion some worthy cause, but cash is still too tight. We should be helping the PCT to save money but that is hard work and properly the expertise of the modernisation people to whom we don't at the moment have access... We are just another impediment to the efficient running of the local NHS, not really an asset. Just another attention catching idea that is immensely difficultt make work."
Despite its disastrous start the CPPIH has been promised another £33m this year. But who is accountable for it? Allegations abound that Sharon Grant was only given the commission chair after she failed to win the Labour nomination for her late husband's Tottenham seat and the victor, junior health minister David Lammy, wanted to reward her. In her acceptance speech Grant echoed Lord Hunt in wanting to make the commission "the uncompromised voice of the patient heard at every level of the NHS". A year on and the silence is deafening.
Meanwhile Hunt, now chair of the National Patient Safety Agency, has launched a National Reporting and Learning System for medical errors, and will pilot it in Wales -with the help of the few community health councils he was unable to abolish. Apparently the new English forums aren't up to the task.
Private Eye No 1106 14-27 May 2004 page 10