Andrew Lansley seems to have, at last, conceded that there may just be a lack of transparency in the arrangements for GP consortia. Many of us have been saying that from the beginning. There will have to be big changes to make the consortia open and accountable to local people.
It certainly looks like the GP commissioning board will be widened and it needs to be. The government may well concede and include a wider group – representatives from other medical staff maybe, Local Healthwatch perhaps, but what about councils? Mr. Lansley (and David Cameron at a recent prime minister’s question time) seem to be ruling out councillors – they say they don’t want politicians interfering with clinical decisions. But the decisions GP commissioners will make are not just purely clinical – they will profoundly affect communities as well as individuals. And councillors being involved will strengthen democratic accountability.
The health and wellbeing boards, including GP consortia representatives, will provide some sort of strategic background for the GP boards, and GPs will have to cooperate with local authorities on the joint health and wellbeing strategy, but the health and wellbeing will still have only limited influence on GP consortia. So surely having a councillor on the GP commissioning boards will mean more effective joint working, as well as sharper scrutiny.
So we should push for elected members on the board, and if that is a step too far for Mr. Lansley, then for directors of social care and of children’s services to be on there. Ideally it should be both.
