Focus on health scrutiny: IRP Essex cancer scanner review
2017 is shaping up to be a bumper year for NHS service change proposals in England being referred to the Secretary of State for Health by local politicians. And that means a bumper year for initial assessments by IRP, the independent body that advises the Secretary of State.
We saw just two initial assessment letters in 2016. The assessment letter IRP published on 18 October responding to concerns raised by Thurrock Council about the location for a specialist scanner, is the fifth IRP has published this year and we’re waiting for more to progress through the system.
Local councillors are uniquely placed to understand public sensitivities around changes to local health services, so it’s no surprise that NHS legislation gives them a crucial role in overseeing health service change programmes. The role is important and the legislation sets out responsibilities for NHS and council leaders to make sure the process is effective.
The IRP’s assessment of the Thurrock referral is a timely reminder of the requirement for councils to formally join together to scrutinise proposals that affect more than one local authority area. In this case it seems Thurrock councillors declined to take part in a joint scrutiny committee and instead dealt with the matter on its own. The process is there for good reason and not following it risks weakening whatever good case a council has for making the referral.
The regulations allow councils to come together to form joint scrutiny committees whenever they see fit. The same regulations require councils to form a joint committee when “a relevant NHS body or health service provider consults more than one local authority’s health scrutiny function about substantial reconfiguration proposals”. The rules mean where a section 30 ‘mandatory joint health scrutiny committee’ is in place, only the mandatory committee is allowed to respond to the consultation; exercise the power to require information about the proposals to be provided to it; and require people from the relevant body to appear before it to answer questions relevant to the proposals.
The power to make referrals to the Secretary of State for Health is different. Councils can choose to delegate that to a mandatory joint scrutiny committee, or retain it. So the rules would have allowed Thurrock to participate in the mandatory committee and still consider the matter of referral alone. Would it have strengthened their case to have done that? It’s hard to envisage that following the required process would have weakened it.