Clause 9 - Variation of authorisation
Health and Social Care (Community Health and Standards) Bill
9:30 am
Sir George Young (North West Hampshire, Conservative)
I shall speak in favour of amendment No. 139 because it raises issues that may be more important than my hon. Friend the Member for West Chelmsford realised. This is the first point in part 1 of the Bill at which the involvement of local government and social services is mentioned, and it underlines the need for the regulator
to have regard to the views of local government. The Government are keen for good co-operation between health services and social services.
Concern has been expressed to the Select Committee on Health that when the concept of foundation care trusts is being developed, emphasis may be placed on acute services, and the needs of the wider health economy may be disregarded. The King's Fund posed the following question about foundation trusts:
''Has foundation trust status had any impact on relationships within the local health economy, particularly with respect to collaborative working, predominantly for the care of older or chronically ill patients?''
We have discovered that social services will not have a place, as of right, on primary care trusts; that is a matter for discretion. However, it is essential that foundation care trusts have regard to the needs of social services. If the route of foundation care trust were taken, there is a risk that loyalty to a popular local institution—namely the district general hospital—would be promoted, and other claims on the health economy disregarded. For example, there may be a focus on the reduction of waiting times for elective treatment—an issue that we all understand—but there may also be other priorities in the local health economy. Unless the regulator or someone else stands back and examines the broader picture, there is a risk that resources will not be applied as they are best needed.
If the focal point is the district general hospital, a community hospital that comes under the wing of a foundation trust may be sacrificed for the perceived interests of the DGH. I suspect that many constituencies have both DGHs and outpost hospitals. In my constituency, the DGHs are in Winchester and Basingstoke, but there is also a community hospital in Andover.