Working with Public Health Professionals

lclg-logoLast Monday saw me travelling to Bristol to have dinner with the latest cohort of Public Health England Professionals attending the Leadership Centre for Local Government programme about working in a Political Environment. ahead of working with them on the Tuesday to help them develop their understanding of the political processes in Local Government. Alongside me was Cllr. Roz Gladden, who is the Deputy Mayor of Liverpool City Council and Cabinet Member for Adult Social Services, representing Labour Councillors and Cllr. Howard Sykes from Oldham Council who is Leader of the Liberal Democrat opposition group and has held various positions over a long and distinguished Local Government career. We joined the cohort midway through a two day course and to informally chat and gather some insights as to how we might tailor the sessions the following morning.

In short we do a sort of triple act discussing firstly why we got into politics and what keeps us interested, then we have a Chatham House question and answer session where the delegates were able to ask us at the differences and similarities of the various political parties and our own personal approaches to problem solving. Then we worked around the various tables over the course of the rest of the session exploring different scenario and ways to work with Councillors in this their new political environment.

As you discuss their issues you certainly do reflect on your own council’s approaches and the problems they face and in part this is what makes this work so worthwhile. As with all services over the coming years the backdrop of reduced funding is the new lexicon and Public Health is starting to develop its voice and narrative as to why it’s role in important in Councils and the lives of residents; and courses like this one are a part of that understanding and so I am pleased to play my small part in the process.

Political Determination

Mildenhall Lodge opening

Mildenhall Lodge opening

Last Friday I attended the official opening of the New Mildenhall Care Home built by Care UK to replace the former County Council home at Wamil Court and what a splendid new facility it is.

Care UK will open, over the coming months, 10 similar new care homes across Suffolk investing some £60M in the process. As per my promise when I visited every single one of our 16 ageing care homes to meet with residents families and staff, in my former role as Cabinet Member for Community and Adult Social Services, all of those residents in Suffolk County Council’s former homes who wish to, will transfer across to a wonderful new home supported by the county council, that is now happening.

At the recent political training sessions I was involved in for both Director of Public Health and Directors of Social Services we talked a lot about what motivates a Councillor to get involved and of the ‘quality’ of Leadership.

I put forward my personal view that whilst there are many reasons people enter politics, I entered to firstly represent my community which I work hard to do and secondly to make an actual difference. It is all too easy to appear to be busy, fronting this and that decision or policy when in reality those would have been Council policy and decisions irrespective of if you or another person from your own or another party was fronting them, the council would make those decisions if you were there or not and there are many of those.

In respect of Supporting Lives, Connecting Communities, a number of great new mutuals delivering outstanding services to some of the most vulnerable in our Suffolk community, at costs lower than before (thus protecting front line services) and in respect of the replacement of all of Suffolk County Council’s care homes with something to be proud of, I was the key political decision maker. Of course I was ably supported by a great officer team who made it happen and colleagues who backed me but it was my political vision and determination often in the face of quite challenging opposition that made these things happen.

That, to my mind is the great challenge of being a Councillor, to have made an actual difference, rather than simply serve your time, to be a journey man if you will. In doing so you’re not always going to get right but at least you will have made a difference.

Working with Directors of Adult Social Services

Ashbridge Business School

Ashbridge Business School

Last Thursday I was asked to take part in a new training course by the National Council Skills Academy for Social Services, for newly appointed Directors of Adult Social Services. The session I was involved was about working in a Political environmental and was a part of a 3 day course. On this programme Directors from across the county got to stay in the splendid surroundings of the Ashbridge Business School in Herefordshire. Ashbridge is a wonderfully grand former stately home, now open to the public at the weekends but during the week it is one of Britain’s top business schools, and what is unusual about it, is that it’s run by a charity and so the hiring of it as a venue for courses would be on a par with any hotel or conference centre but in a stately home.

In some ways the sessions I help deliver are similar to the work I am doing for Directors of Public Health in that I work alongside Liberal Democrat and Labour councillors. We focused more on our personal journeys into being a councillor but in the workshop sessions the discussions were about that key issue for Directors about finding they place and influence, their personal authority in a council world of hieratical authority.

One of the really interesting workshop conversations I was involved in was about the nature of accountability in Local Government set against accountability in the NHS. A large metropolitan or county council has many thousands of employees and complex systems yet if a resident has a problem they speak to their councillor and their councillor speaks to a Director, for all the vastness and complexity that is a two person chain. Set against the NHS where you have Health Watch, Foundations Trusts with massive friends groups and bodies, Governors draw from clinical professionals and the friends, the CCGs, the SHAs and NHS England, in short whenever you seek to get an answer from the NHS and ask who is responsibility they all point up the line or at each other, something the Francis report into Mid Staffs Hospital picked up on, perhaps so much accountability there is no accountability? Perhaps there is something in this democracy thing after all!

Police and Crime Commissioner what about a Health and Care Commissioner

This week the Prime Minister David Cameron said that he wants health and social services to work better, work differently and work together for the benefit of all but especially the care and support provided to older people. I could not agree more. It now looks like their will be a formal duty to co-operate, which is essentially the requirement of the Health and Well Being Board.

This government has done more in 18 months to shift the decision-making on Health than the previous government did in 13 years. The creation of the Health and Well Being Board is so fundamental, so significant, yet few outside the system realise the beneficial impact it will have on the stated aims of our Prime Minister and the aspirations of many of us, patients, families,and  staff, including myself in my role, who have to grapple with the system on a day-to-day basis. A system that the Prime Minister rightly says must do better.

Yet it also seems to me this is but a step and should only be a step towards a Health and Care Commissioner. The Police service is an incredibly important part of our lives but in terms of public interest, spend and number of people employed the Police service is but a minnow compared to the health service in all its many forms, it is true to say the police service is one organsiation whereas health is and will remain a collection of providers and services but all the more reason, I say.

As with the Police and Crime Commissioner an accountable person who has the mandate to hold Health’s Hospitals, GP’s and a range of services providers and the social care system to account in each area and to be held to account on this issue that after the economy is of the greatest concern to all of us our National Health Service.

I have the political responsibility for the care services in Suffolk, and as such am accountable for them. It is a significant responsibility but social care is only a part of a person’s journey and at times it feels a bit like playing tennis with one hand tied behind your back very, very restricting. Whilst the Health and Well Being Board is the place we can begin to join services together; ultimately elected Commissioners would have the mandate to drive and deliver the vision David Cameron set out last week.

The police service in Suffolk employs 2,400 people, the health and care services across Suffolk employs tens of thousands of staff. The police service has a net annual spend of £114.6 million; the health and care services spend runs into the billions, it is so vast in fact, that one of the first jobs of the Health and Well Being Board is to try to put down in one place exactly how much and how many people are employed across all the services. Adult Social Services alone spends more supporting older and vulnerable adults than double the entire police budget.

As was reported in various commentaries the most thorny outcome of a better service was sumed up by the NHS confederation’s deputy policy director, Jo Webber, said: “Integrating care will improve services, particularly for people who are frail and those with long term conditions. But it will also involve making some really difficult decisions as hospital activity is reduced and moved into the community.” Who better than an elected Commissioner to explain to communities why this traditional ‘red line in the sand’ for most residents and indeed Politicans is in fact a good outcoem not some thing to take to the streets over.

If it is right to have true democratic elected leadership in the policing service it is right in the health service, it’s a simply as that.

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