How Yvette Cooper can demonstrate Andy Burnham’s new ways of working in practice
Central to his vision for a new kind of politics that Andy Burnham outlined when he first stood on the steps of Downing Street as Prime Minister was a commitment to listen to those outside the system; a new approach that will enable them to speak truth to power. He said he wants this moment to be “a circuit-breaker for Britain.”
Yvette Cooper has an early opportunity to demonstrate that change in practice as the new Secretary of State for Health and Social Care by affirming the right of patients and the public to an independent voice in shaping the services that they rely on.
The principle of independent voice in health and social care has been recognised for fifty years and goes back to the days of Community Health Councils. Bizarrely, however, it was a principle that Keir Starmer’s administration was trying to destroy.
Just before Parliament rose for the summer recess, the Government’s Health Bill completed its passage through Committee in the Commons. The Bill was published when Wes Streeting was Health Secretary and much of it reflects the forward-looking approach that Wes Streeting brought to most of his work in that role.
Inexplicably, however, he also included in the Bill a plan to scrap both Healthwatch England and the network of local Healthwatch organisations around the country that speak up for patients and the public and hold NHS and social care services to account. Local Healthwatches also directly provide information and signposting services to help patients and service users navigate their way through a system that is too often opaque, remote and unresponsive.
Wes Streeting said he wanted to bring these functions “in house”. Under his plan, Healthwatch England’s functions would be taken over by a new Directorate in the Department of Health and Social Care. Local Healthwatch services, meanwhile, would be divided between NHS Integrated Care Boards and Local Authority commissioners of social care. In other words, by bringing Healthwatch functions “in house”, the key principle of independence will be lost.
The plan has already come under fire from a wide variety of organisations with deep experience of health and social care. The respected King’s Fund think tank, for example, has said: “Healthwatch’s independence has ensured it’s been seen as credible by communities and allowed scrutiny of issues the health and social care system may overlook.”
Put more bluntly, it is just not good enough for the system to mark its own homework. That was a lesson that was clear from the Mid Staffs Hospitals scandal of the early 2000s and it has been graphically underlined more recently in damning reports into maternity services in Shrewsbury and in Nottingham, and in the investigations that are ongoing elsewhere.
It was therefore heartening to hear Andy Burnham unequivocally declare his support for the retention of independent public voice both as Mayor of Greater Manchester and as candidate for Makerfield.
Yvette Cooper will have a lot on her plate as the new Secretary of State for Health and Social Care but she has an early opportunity to put our new Prime Minister’s words into practice by drawing up amendments to the Health Bill before it returns to Commons in September ahead of detailed scrutiny by the House of Lords.
I chair Healthwatch Birmingham and Solihull. We are one of the biggest Healthwatches in England. I know the impact we have had both in helping to reshape services and, where necessary, shining a light on bullying cultures that the system allowed to remain hidden for too long.
So is the current structure of the Healthwatch network perfect? Of course not. For example, the hit-and-miss mechanisms through which local government currently funds local Healthwatch has meant that our impact has been uneven across different parts of the country. That is why, for over a year now, a network of local Healthwatches working together has been offering to work collaboratively with Ministers to identify ways to make the voice of patients and the public even more effective while preserving the vital principle of independence. Unfortunately, Yvette’s predecessors did not respond to our offer of dialogue. Indeed, they did not consult the local Healthwatch network before they published the Health Bill or invite us to give evidence during the Bill’s scrutiny by Parliament so far.
Yvette Cooper can now change all that. She can open her door to dialogue. She can make clear that, under her leadership, the Department of Health and Social Care will recognise that patients and the public have the right to a voice that is independent, not simply one that is filtered by officialdom.
In short, she can make the “circuit-breaker” in government culture that Andy Burnham has promised a reality in health and social care.
