On the conference motion

A quick aside. In my previous post, I said I disagreed with some of the points in our conference motion. Here’s the list, and my reasoning:

3. Secretary of State to remain responsible for the final decision, if needed, when major service changes are opposed by local democratic scrutiny bodies on behalf of their community.

If we are serious about devolving decision-making to local bodies, this seems odd. The whole point of localism is to allow local decisions. The point might be okay if it defined “major service changes”.

8. The commissioning function (i.e. not back office functions) to be carried out directly by public authorities rather than subcontracted to non-public bodies; using public sector staff and employing the skills of existing PCT staff

Why? The commissioning function should surely be carried out by the Commissioning Consortia, otherwise what are they for?

9. Unless Commissioning bodies have a majority of councillors, there must be scrutiny of all commissioning decisions by local elected councillors either through the local authority, Overview and Scrutiny Committees, or Health and Wellbeing boards (which must have a majority of councillors to fulfill this role)

My concern here is that commissioning bodies remain clinician-driven, not local political entities – one clear goal of the legislation is to remove political interference. It is fine for commissioning bodies to include councillors but the majority should be clinicians.

16. Complete ruling out of any competition based on price for tariff-based services (and not just at the point of referral or the point of patient choice);

Why? If all else is equal (e.g. quality, timeliness, etc), why rule out price?

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