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(man) Ladies and gentlemen, welcome.
We're just about to begin our event.
Ladies and gentlemen, welcome to this extraordinary, exciting day
for user voice in health and social care and indeed in public health.
This is the launch of the Healthwatch network.
My name is Bill Lucas and I'll be your facilitator for the afternoon.
This afternoon, Healthwatch England
is hosting a series of five simultaneous events
in Birmingham, Leeds, Manchester, Taunton and here in London.
Just a few housekeeping notices. If you're a tweeter and want to tweet,
then #Healthwatch is what you need to do.
Otherwise, wherever you are,
perhaps be kind enough to set your phones to silent.
This is being webcast at the same time,
and indeed being recorded if you're unable to be with us now.
And all the presentations and all the material
will be available from the new Healthwatch website.
Before I come to our distinguished panel of speakers
to launch the network formally, let's just go to each of our regions
to get a flavour of their discussions this morning.
You can see where we are now on the screen.
And we're going to go to Birmingham first.
I'd love to invite whoever speaks just to be so kind as to tell us who you are
and give us a very short summary of the issues that are being raised with you.
Greetings from Birmingham.
I'm Jane Mordue, Healthwatch England committee member.
One of our chairmen put it well this morning.
He said, "This is serious stuff,
and it's time for us to step up to the plate."
And here, we're very clear about the task ahead,
which is to get evidence of where things are going wrong
and to track those things robustly, to make sure that we can make a difference
to amplify the voice of the patient as a consumer.
This morning we had a look at some of the priorities
that we think are likely to come top of our list,
such as what can be done to better integrate services
in the NHS and social care?
What about children and young people?
What about the impact of personal budgets?
Those are some of the priorities we looked at.
We've also shared a few worries in a very open and supportive atmosphere.
How can we ensure that every local Healthwatch
is as good as all the others?
How can we make sure that the public know we exist
so that they don't say, "Healthwatch, what's that?"
Those are a couple of the challenges, but overall I can say
there's an incredible spirit of energy in this room,
and a lot of open sharing of ideas and thoughts,
and, basically, we're ready for the off. Thank you from Birmingham.
Thank you very much in Birmingham. Now we go to Leeds.
Hello from Leeds. I'm Jane McFarlane,
committee member for Healthwatch England.
We have a very enthusiastic and committed audience here in Leeds.
And a very clear message from us here
is a clear hope for the future of Healthwatch,
that it will make a difference and will add value.
We've heard today from a consortium approach
of Leeds local Healthwatch consortium,
which is all about partnerships, about working together, about core production,
about core design and making the most of each other's strengths.
We've also heard from commissioners
who are equally as committed and want this to work.
So we feel that the environment is right for Healthwatch to succeed.
We talked about early involvement to make it meaningful,
an actual meaningful engagement with people.
We also had a plea from previous LINk members to remember the legacy of LINk
and the enthusiasm of former LINk members
who really want to be part of the movement of Healthwatch.
One of the key concerns that is coming through with us in Leeds
is the longevity of Healthwatch. How can we avoid yet another change?
Can we have some consistency for the future
so that Healthwatch has a real chance to make the job a good one?
- Thank you. - Thank you so much in Leeds.
I know that issue of sustainability was a question that came up this morning
and will, I'm sure, come up later on.
We go to Manchester.
Good afternoon from Manchester.
I'm Ruth Walkden from Healthwatch Trafford.
Our morning has been spent receiving an update from CQC
on how they want to work with all the local Healthwatches
in health and social care.
We also looked at the way
the Greater Manchester Healthwatch work as a network,
an example being the new contract for patient transport.
Everybody took part in a workshop
looking at how they could work with their neighbours for better outcomes.
We thought that leadership and cooperation
with board members, volunteers and staff was essential.
Thank you very much. Especially succinct.
And now to Taunton.
In Taunton I was struck by the poll we had
showing the values that we regard as important.
And independence and integrity came out overwhelmingly
as the most important issues for us.
We had a World Café approach where we moved around the tables,
writing on the tablecloths
about the values and tasks that we have for the future.
One big point I drew is that,
speaking as someone on the Healthwatch England national committee,
we shouldn't be afraid of actually providing helpful guidance
to local Healthwatch.
For example, there's no point
in everybody having to reinvent the same wheel
and that locally, on matters perhaps of governance,
on issues of mobilising volunteers,
there was an appetite for some helpful intervention from the centre.
I know we've been doing some of this. For example, only this week
we've been looking at the issue about how we expect local Healthwatch
to be able to campaign.
I know there was some stuff about
whether the regulations from the government were against campaigning.
We've put matters right on that
and I'm sure if Jeremy Hunt has anything to say on that subject,
we'll hear from him later in the afternoon.
So we, too, are raring to go
and looking forward to the rest of this afternoon's proceedings.
Thank you very much. A bit of advance notice for the Secretary of State
about what he might be asked. That's splendid.
You'll see that we've tried to model a certain local diversity,
so that each of the regional events has been very much
up to the Healthwatch groups that have been creating it.
Finally, here in London, it has been my pleasure to be here,
and I'm going to turn to Mike Adams
who will tell us what we were up to this morning. Mike.
Thank you very much. I am chair of Healthwatch Essex.
We discussed this morning what a great opportunity it is,
and I think Leeds said, to make a difference,
and to make the voice of citizens heard and part of the solution.
So it's not just about saying what the issues are,
but saying how, together, we can then find solutions.
We know there are great challenges, but we are ready
and up for meeting those challenges
and to ensure that the voice of citizens are that.
We discussed in practical terms the importance of governance
and the importance of delivery and the importance of doing things.
We talked about perhaps doing less, but doing it better.
And we talked about the concept of both voice and lived experience.
Those individuals who may be frequent users of health and social care.
Those who have never even come into contact with health and social care,
but will do in its future.
And then we talked about the role of Healthwatch representing that voice.
The need for Healthwatches to be strategic,
the need for Healthwatches to be nimble,
and the need for Healthwatches that understand
how they can best influence and make that impact.
Thank you very much indeed, Mike.
Thank you, all of those who've given feedback
from our five different regions.
Now, between the time where we are at the moment and three o'clock,
we'll be doing three different things.
We're going to hear from a number of leading experts in the field.
They're sitting on the stage now. We are going to have an opportunity
to raise some of the issues generated at our regional events
with the Secretary of State for Health, Jeremy Hunt.
And then we're going to continue our discussions with a live panel debate.
That will be webcast, so that could be live wherever you are in the world.
First, it's my pleasure to introduce the Secretary of State for Health.
Jeremy Hunt was elected MP in 2005.
He's held a number of ministerial roles, including, to great acclaim,
Secretary of State for Culture, Olympics, Media and Sport.
In September 2012, he was appointed Secretary of State for Health.
Please put your hands together
and welcome the right honourable Jeremy Hunt MP, Secretary of State for Health.
Good afternoon, ladies and gentlemen. Isn't technology wonderful?
This is so impressive to see this happening.
I'm not at all surprised that you have a Twitter feed of today's events.
I'm greatly relieved that...
In my last portfolio I was also responsible for the technology industry,
and I went to speak at a conference on social media
where they actually had the Twitter feed on the screen behind the speaker,
and the speaker couldn't see what people were actually saying about him.
It was a conference on social media,
and someone tweeted, "Jeremy Hunt doesn't really understand social media,
but he's trying very hard."
That was a farmer's wife from Cumbria. So, anyway...
I'm delighted that you're not doing that.
Thank you, Bill and Anna, for that.
I had a reminder this morning of just how Twitter is changing things,
because part of the Department of Health's response to the Francis report
into what happened at Mid Staffs
is a decision that everyone in the Department of Health
should have frontline experience in the NHS,
because the department was itself criticised very heavily
for not knowing what was going on on its own frontline.
So as part of that I have been going around
and doing things on the frontline.
This is very much actually rolling your sleeves up and taking part,
not just visiting, without media.
This morning I was in the A&E department at Watford,
which was a fascinating experience.
But it didn't take long before it was out on Twitter
and the whole world knew that I was there.
It did bring home to me something that I think is really important
as a starting point for all of the work that I do and you do
to articulate the voice and the rights of patients who use the NHS.
And that is the respect that we must feel for the frontline professionals
in the NHS who are under incredible pressure.
I think it's worth reflecting on some of the pressure that they are under.
In A&E, for example,
we are seeing in England a million more people every year in A&E
than we saw just two years ago.
There is a huge increase of activity.
That puts pressure on one part of a hospital
that ripples out throughout the whole hospital.
It isn't just the numbers; the acuity of the people who are going into A&E
is increasing very dramatically as well.
The NHS budget has been protected,
but it hasn't increased by a huge amount.
Within, essentially, the same budget in real terms,
the NHS is now doing about half a million more operations every year,
around three million more out-patient appointments every year,
and that is all happening because people inside the NHS are working very hard
to make sure that we can deliver what we all want from the NHS.
It's an important starting point in a period when I think,
rightly, as a country, we've decided that we have to be more open
about when things go wrong in the NHS,
that we also recognise how hard and how dedicated
so many people are inside the NHS.
As Health Secretary, when I reflect on the direction the NHS is going,
it feels to me like we have realised that
a top-down, centrally driven, target-driven NHS
is not in the end going to deliver the personalised service
that people expect or want or need.
And so we're moving to a much more patient-driven approach.
That is the right thing.
But when you look at the biggest individual challenges facing the NHS,
it's even more the case.
Because if I look, for example, at the challenge of dementia,
which is something, with an ageing society,
that we are having to face up to,
what you need if you're going to give people
the care and the dignity and the respect that they need
when they've got a condition like dementia, a horrible condition,
you need a service that actually puts the patient at the heart
of the way they're looked after,
that looks at the person and not the condition.
That is a very big change in terms of the way that we approach the service.
If you look at the whole question of integration more generally
and the way that we discharge people from hospitals into the community,
I worry about the fact that whilst, when you're inside a hospital,
there is a consultant who is responsible for your care,
when you leave that hospital,
very often there doesn't seem to be a medical professional who is there
and responsible for your care in a proactive way
that would happen inside a hospital,
despite the fact that so many of the people who are going into the community
from hospitals are leaving with long-term conditions
which are going to be always part of their life
and need proactive case management.
If we're going to crack these really big challenges,
the only way to do it is to think about the issue
from the patient's point of view, from the person's point of view,
and not from the point of view of the needs of the institution,
the needs of the hospital, the needs of the system.
And that for me is the biggest single lesson
of the Francis report into Mid Staffs, that we allowed in some parts of the NHS
a system to develop
where the institution mattered more than the person.
And there is no professional inside the NHS who ever wants that to happen.
And we have to recognise this is not an issue about a few bad apples,
this is an issue about a structure, a system,
that all too often makes it hard for people
to be the compassionate caring people they went into the NHS to be.
And what I have to do and what all of us have to do
when we're speaking up for patient voices is to be the advocate
that allows those frontline professionals
to deliver the kind of compassionate care that they want to deliver.
And we have to recognise that provides some very real challenges
in busy hospitals and busy wards and busy GP surgeries,
and that is one of the central things that we need to tackle.
So all of that is really, I think, a long-winded way of saying
that the time for a really strong independent patients' voice has come.
We've had patients' bodies before
and we can learn a lot from the way they operated.
I think the key thing for Healthwatch going forward
is that I hope we've found a structure that will avoid the twin dangers of,
on the one hand being a patients' voice that is more about process
than about real change, we certainly don't want that,
but on the other hand being a patients' voice that is able to become hijacked
for political campaigns. I know that no one would want that to happen either.
Getting that middle course right, a strong, independent voice,
yes, able to campaign, but on a non-party-political basis,
must be what all the patients in the NHS
whose voices you are speaking up for would want most.
Let me just finish.
This is a week when we have been reflecting on great prime ministers
who have shaped our country's history and destiny
and if I go back before Margaret Thatcher to Winston Churchill,
he said that courage is what it takes to stand up and speak out.
And I think all of you in Healthwatch are the people
who are going to be showing that courage to stand up and speak out
for people who don't have the strongest voices,
but who desperately need someone who can be that voice for them.
So I want to wish you every success
going forward on this really exciting launch,
and I want you to know that you have my wholehearted support
in the incredibly important work that you're doing. Thank you very much.
Secretary of State, thank you very much.
We have the chance to have more of a conversation in about 15 minutes.
It's my pleasure now to introduce Anna Bradley.
Anna is a long-standing consumer advocate and experienced regulator,
I'm not sparing her blushes,
and independent member of the Care Quality Commission,
and absolutely the right person to be chair of Healthwatch England,
which indeed is what she is.
Please welcome Anna to the stage now. Anna Bradley.
Thanks very much for that generous introduction, Bill.
Good afternoon to everyone here and elsewhere.
This is such an important day for me, and I hope for all of you.
It seems an incredibly short while ago
when six months ago, we launched Healthwatch England
and we talked about local Healthwatch as a rather abstract thing.
Now here we are ready to launch the Healthwatch network.
My sense of today is that that's 152 new organisations
who are absolutely cram packed full of ambition
and who really want to make a difference for children, young people and adults
who use services now or will do in the future.
So it's fantastic to see so many of you here
via this incredible technology, which has worked.
I hope also so many people up and down the country,
and I hope you can still see and hear me.
I'd like to say thank you to all of you for being here today,
but perhaps a special thank you to Jeremy Hunt for joining us
and giving us his good wishes, and to Victor Adebowale and Mike Adams,
who you'll hear from shortly. Nice to have you all sharing today with us.
The last six months have been extremely busy
and very exciting for Healthwatch England.
During that time I've had the opportunity to meet many of you
at our regional road shows and stakeholder events.
That's been a fantastic pleasure.
One of the things that I've been hugely struck by
is the talent, experience and commitment that is available to this network,
which should give us a huge advantage.
There's all the experience
brought by those moving into Healthwatch from LINks.
There's a huge amount of new talent and energy
which is being made available to us by people who are moving into this work
from other sectors and who see it as something they want to be involved in.
And there's a deep knowledge and experience
provided by an array of partners in the third sector,
representing many thousands,
in fact hundreds of thousands of individual members,
and I want to say a very warm welcome to all of you, too.
As this network has emerged over the last few months,
we've been finding out who you are.
I said in October it was going to be like Christmas Day,
and it kind of has been.
I want to celebrate the diversity that is local Healthwatch.
Nearly two-thirds of you say you are setting up
as some form of social enterprise.
A quarter are seeking or already have charitable status.
21 of you have transformed from LINks.
We've got CSV, Citizens Advice, Help and Care,
Voluntary Action, Carers Federation.
These are just some of the household name organisations
who have been commissioned to drive local Healthwatch forward.
We look forward to working with you all.
I truly believe that that diversity will help to ensure
that there's real innovation and fitness for local purpose in Healthwatch.
And I see it as our role at Healthwatch England
to help you learn from each other
and to develop a sense of what good looks like
for consumers and users of health and social care
who are frankly depending on us to do a really good job for all of them.
In the next ten minutes I want to do three things.
I want to restate the importance of our role.
I want to illustrate what it is to be a consumer champion.
And a want to emphasise the significance of a Healthwatch network.
First of all, why our work matters so much.
There's a sense in which our task is self-evidently important,
but I think there are two things which make it especially important right now.
Jeremy has already alluded to them.
One is the scale of change in health and social care,
and the other is the context of the Francis report.
The events at Mid Staffs, at Winterbourne View and indeed elsewhere
give us what I think is a really strong mandate.
Running throughout the Francis report is the need to change culture
and to make sure the needs of patients or consumers are number one
in the minds of those who plan, run and regulate our services.
Our mandate is to make sure
that the voice of the consumer or the service user,
or indeed the patient, is heard loudly and clearly.
That will not always be easy in a system with so much change,
a system that's having to make some very difficult choices
about how to reshape services.
We have to keep everyone really focused on what matters most
to consumers and users of services.
A challenge, but one I think we'll be able to meet
if we do two things in particular.
The first of those is to connect with our communities
and feed in our own evidence about what matters most to people on the ground,
whether those are children, young people or adults.
I believe we've got a particular responsibility
to focus on those whose voices are seldom heard,
those who have no voice and no advocates.
Local Healthwatch will be doing the same, making new connections
and finding new ways of engaging with your communities.
The second thing we need to do is to challenge those
who plan, run and regulate services to be better, and I mean much better,
at engaging and talking to consumers of services about what they want and need.
We need to hold those providers to account
to do it right and to do it well,
putting consumers and users at the centre of what they do
and not seeing engagement and involvement as simply gathering data
or ticking a box at the end of a process when they consult.
The Healthwatch network is not an alternative
for these statutory organisations to meet their responsibilities.
We won't do that work for them,
but we will make sure that they do it on behalf of consumers.
My next theme is about bringing that idea of consumer championship to life.
I guess when I took on this job, I knew we had a very big task ahead.
We have to influence an extremely large
and very complex and well-established sector,
not withstanding the change.
Yet collectively we are relatively small and we are very, very new.
It's important, then, that we are not intimidated
and have the confidence to speak out
on behalf of consumers, users, patients, carers, call us what you will,
asking those commonsensical questions that should cause all those expects
to stop in their tracks and think again about what they're doing.
I don't think we have to learn how to speak health and social care,
I think health and social care needs to learn how to speak consumer.
As one American politician, Christine Todd Whitman, said,
anyone who thinks that they're too small to make a difference
has never tried to fall asleep with a mosquito in the room.
I know from having met many of you over the last period
that you will certainly have a bite.
I've worked in the field of consumer advocacy for many years,
and in many different sectors,
and for me, the role of consumer champion is pretty well established.
It boils down to starting with the consumer or person in the round,
with their needs, their experience, not with the needs of the system
or professionals or policy makers, but our needs as people.
It's rooted in consumers' experience and an evidence base.
We are independent and challenging as consumer champions,
and above all else we influence to improve things
and we're focused on what will work for consumers, the outcomes that they need.
I feel very comfortable, frankly,
with the idea of bringing the concept of consumer rights
into the world of health and social care.
I know it's a bit controversial, but for me,
consumers have well-established and well-recognised rights.
Things that are just that, rights,
like the right to safety, to be informed, to choose, to be heard.
They're standards that people feel entitled to receive,
no matter who they are
or what part of the health and social care system they are using.
One of our major priorities at Healthwatch England for the coming year
will be around one of the most basic of consumer rights,
the right to redress or complain or give feedback.
We know from our own research and work carried out through LINks
that complaints are a major issue across health and social care,
and particularly in primary care.
Last week we commissioned a YouGov survey
to find out some research on this issue.
YouGov talked to just under 2,000 adults in England
about complaints and feedback in health and social care.
This is a topic we'll come back
and have a lot more to say about over the next period,
but I've got some early results for today,
and I'm afraid they confirm all my worst suspicions.
Far too many people are not complaining when they feel they have cause to do so.
We don't complain because we find it too hard to do so,
we don't feel anything would change if we did,
or because we're worried it will compromise future treatment.
Almost half of us have no confidence in the complaints system,
and yet three out of four believe that being honest when things go wrong
is really important. That latter certainly reinforces for me
our support for the statutory duty of candour as recommended by Francis.
But taken together, this is a pretty bad state of affairs it seems to me.
It means consumers and users will, at the very least, remain disgruntled,
and it means the system is missing the opportunity to improve.
That's perhaps the most important thing.
We will be doing much more in this area over the coming year.
We'll particularly focus on those who don't have a voice or are seldom heard.
I believe if we can make it better for those who find it hardest,
we will all benefit.
I'm quite sure that part of the required improvement will be about process.
But another part of the solution
will involve a change in culture and attitude.
Complaining should be easy, and, in an ideal world,
complaints and feedback should be welcomed
as a chance to make things better rather than being seen,
as I fear they are by many, as a charge to be defended or denied.
But I don't actually want us as the Healthwatch network
just to focus on making the existing system better.
I'd like us to be more ambitious than that
and focus on the real prize of changing the systems we have where we need to.
By staying focused on what's best for the consumer or user,
I believe we can truly achieve this.
Our aim should be to focus on those areas where we can bring real value.
As consumers, as Jeremy has already said,
we don't experience life in little packages of health or social care
or home care or primary care or even long-term conditions.
We're people with a series of needs, often complex.
Of course, while there is a lot of emphasis on hospitals at the moment
because of Francis,
and there is some very important work that needs to happen,
actually, if we, Healthwatch, know that consumers are more concerned about
primary care or about the interface between hospital care and home care,
then that's where we should be focusing our efforts.
We need to set the agenda rather than just respond to what others are doing.
We can only set the agenda if we have the evidence
and we have the partnerships to argue powerfully and credibly for change.
That's where the Healthwatch network comes in, so my third and final theme.
It may be a cliché, but nevertheless,
our collective job is to make sure that the network as a whole
is greater than the sum of the parts.
It will take time for us all to be up and running fully, I know that.
But the regional meetings this morning and our event now
are the start of turning policy into intention,
and intention into reality.
So, later today, Katherine will talk about some of the specific things
we'll be doing over the coming year to build a thriving network.
But that work is not just about local Healthwatch.
It extends to the partnerships we want to build between Healthwatch
and local and national community and voluntary organisations,
which is why I'm pleased so many of you are here today
and Victor's on the platform. We don't want to reinvent the wheel.
We know there's already lots of intelligence and knowledge out there
that we can use.
We know that organisations like the Alzheimer's Society,
the Children's Trust, Mencap and the Carers Federation,
all in the room today, I believe,
know far more about the issues facing their members
than we could ever hope to learn,
which is why working with you is so important to us.
In conclusion, then, Healthwatch is very small with a very big job,
at a time of great, great change.
There's a touch of David and Goliath about our role in the system,
but please don't let that deter you.
I want to leave you with one more quote,
this time from the American anthropologist Margaret Mead.
She said, "Never doubt that a small group of thoughtful, committed citizens
can change the world. Indeed, it's the only thing that ever has."
So I say watch this space. Thank you very much.
Thank you so much, Anna.
It's my pleasure now to introduce our third speaker for his input.
He's Lord Adebowale, as has already been advertised.
Victor is a champion for the cause of those affected by poverty,
by mental ill-health, drugs, alcohol, addictions, learning disabilities
and, indeed, those with more complex, cross-cutting issues.
He's currently chief executive of Turning Point.
Colleagues, please put your hands together and welcome Lord Adebowale.
Thank you very much.
It's a great honour to be here at the start of Healthwatch.
I've got to keep to time, the five minutes.
The clock starts now. It's ticking. I'm going to crack on.
My mum was a nurse for 30 years.
And throughout that time, I was always aware of what respect she had
for the clinicians and the health system,
to the point where, to this day, she thinks I'm unemployed.
Because I'm neither a doctor or a priest,
as far as she's concerned, I'm on the dole.
Mum, if you're watching, this isn't what I do for a living,
but they are paying me.
(laughter)
It's a great honour to be here.
I just wanted to say there's a buzz in the room.
The fact that you've got the leadership of Healthwatch that you've got,
and actually the commitment of the Secretary of State, is a good start.
It's a good place to start. In fact, there's not a...
I was going to say cigarette paper, but it's probably not appropriate,
between myself and anything that has been said from the platform.
In fact, the pubs are open, the cinemas are open, that's it, really.
But there are some things that I think I'd like to say to you
both as the chief exec of an organisation that provides services
to people in about 250 locations, and as a member of NHS England's board.
And, please don't hold this against me,
as a member of the House of Lords, I guess.
You watch...
Some people have already decided they're going to hold that against me.
You watch... This is a pivotal moment, in my view,
for the launch of an organisation like Healthwatch.
In the light of Mid Staffs, in the light of the controversy that meets us
virtually every day we open a newspaper, Healthwatch is critical.
You have a massive task, and I think it's important that we recognise that
and recognise it with energy.
You have to represent communities and individuals
who are at the sharp end of the inverse care law,
that law that states that those people who need health and social care the most
tend to get it least. In my view, that's where you start.
Because, as Anna said and as I absolutely agree with,
you need to start with those people
in order to make it matter for the rest of us.
But it's more than that.
As a member of NHS England's board and as the person who signed off 211 CCGs,
I know that it's about commissioning, it's about what we change.
It's about services.
Not just to patients, but to those people that may become patients.
Consumers is exactly the right word that we need to be using
in a modern health and social care system.
And I think it's about holding commissioners and commissioning
to account and defining commissioning as the means by which it understands
the needs of individuals and/or communities
such that it can build a platform that justifies the procurement
and contracting decisions it makes on our behalf.
But your challenge is made more difficult
by the fact that the real challenge lies outside this room.
I am speaking to the cognoscenti.
The real challenge lies with those people who do not know you exist
or do not understand how the new health system works, how it operates,
what it means to them, their families, themselves and their communities.
But you're not on your own. You're not on your own.
Both NHS England, individuals like me,
who run organisations that care about reversing the inverse care law,
are with you.
And we must work together or we will fall apart.
And that, I think, is the big challenge.
The big challenge is the NHS, health system, social care,
is no longer a system, it is a movement, and we have to make it count.
Not just for the people in this room,
but for the hundreds of thousands, the millions, that are outside it.
Thank you very much.
Thank you very much, Victor. I'm sure your mother
would have been impressed by your impeccable timing as well.
It's my pleasure now,
and some of us had the privilege of meeting him this morning.
Some of you are new to our event today, in which case this is my opportunity
to welcome you if you've just joined for the afternoon.
I'd like to introduce Mike Adams. Chair of Healthwatch Essex,
Mike is a leading authority on disability issues.
He's chief executive of the disability charity ECDP, and, most recently,
he's been made an ambassador by the government
for its programme to strengthen the real engagement of disabled people
as users and in driving user-led organisations.
Will you please, colleagues, welcome Mike Adams?
Thank you, Bill. I just wanted to use my five minutes this afternoon
really to reach out to those of you who are going to be involved in the delivery
of local Healthwatches over the next year, two years, three years.
I kind of think to myself, why did I get involved?
I was always interested in health,
and I decided that I wanted to give something back,
and the way to do that was to join the board of a local hospital.
So I became a non-executive.
The first appointment that I had as a non-exec
was to be responsible for complaints and compliments within the hospital.
And I can tell you that, actually, reading those complaints and compliments
actually really changed the way I felt about public service,
and really changed the way in which I was absolutely determined
that we needed, one, to improve where things had gone wrong.
And what I tended to find was where things had gone wrong with people,
they had gone terribly wrong.
And also, and it is really important,
and it's important for Healthwatch to remember, where things have gone right
and where things have been done well, that we get more of it,
or we ensure that there's equal access to that provision.
And therefore, and it's a lesson, I think, for local Healthwatches,
is for those who are complaining, two things.
One, they always said, "I want people to say they're sorry."
And, secondly, they said,
"Let's make sure this never happens to any other family ever again."
And for people who have compliments, they say, "Thank you, NHS,
thank you, social care, and let's make sure other people have access to that."
So what do we draw on?
What are the things that are important for local Healthwatches?
One, we have to remember this is about citizens of the area
that you're going to be involved in.
And your strength will be the extent to which
you involve and you engage those individuals.
And don't just expect them to sign up and be involved.
And I think one of the key challenges
is how do we give back to volunteers and to members?
And part of that, and what I am going to try to do in Essex,
is through training and through enabling people to develop their skills
so they can facilitate lived experience.
And so they're not individuals who can only talk about their own perspective,
but can go to different arenas
and say, "This is what the local community are saying."
"This is their experiences."
And it's so much more powerful when you go,
"This is not what Mike Adams is saying;
this is what 720 people who have completed
are saying about this particular provision."
Part of that and part of our challenge will be to gather evidence.
People say to me, "Does that mean you're not going to do anything
until you got a massive lot of evidence?"
No, because we will need to use our common sense,
and when issues emerge, we will need to deal with them.
But part of the issue will be triangulating to say,
"This is what people are saying; what does this mean, how can we move forward,
what does that mean in terms of a solution?"
We're not going to be able to do everything straight away,
so we need to be strategic about what we get involved in.
And I'm really clear that there's already good infrastructure in place
and networks in place. Work with them, add value to them.
Maybe one of the areas we need to think about is those cross-cutting issues.
People talk about better integration between social care and health.
I talk about better coordination
and making sure that where there are
cross-cutting issues between social care and health,
health/public health, social care and public health,
we can play a really valuable role.
And let's make the issues that we raise current.
Make the issues the ones of today, the ones that are facing people today.
And we will have to be strategic. We will need to work in partnership.
And we will need to ensure that we utterly and totally
reflect the voice of those people that we are there to represent.
I'm really excited about the opportunities.
I'm really worried about the challenges, and I think I said this morning,
a lot of people I've spoken to,
one, think Healthwatches are going to be the panacea for engagement.
They're not. We will utilise existing provision.
And, two, that we'll have it all sorted by June.
- It might be August. - (laughter)
But I think there's a real opportunity.
Let's seize the moment, and good luck. I enjoy working with you.
(applause)
Thanks so much, Mike, for your humour, advice and optimism,
which comes through very powerfully in that.
And that evidence on the power of consumer evidence,
which I know we're going to come back to.
So, now think not quite Jeremy Paxman, or even necessarily the BBC morning
or indeed commercial morning news programme,
but it's my pleasure now
to have the chance to ask Jeremy Hunt a few questions.
Just so you know, if you've just joined us now,
all of these questions have been submitted by colleagues
from our five different centres.
I can't possibly do justice to all of them.
I've been through them very carefully. There are some common themes.
I'll do my level-headed best
to interpret the kind of questions that we've been having.
And the Secretary of State, who can't be with us for the rest of the afternoon,
but thanks for fitting us in now, when he has left,
I have the privilege of the wise people to your left and my right,
and we're going to continue that discussion
and bring colleagues in from our other venues.
So, Jeremy, the first question
is very sharply and very clearly expressed from Leeds.
This isn't the first time.
How do we make Healthwatch better than its predecessors?
Well, I think it's a very important question,
and I think the way to make Healthwatch better than its predecessors
is not to pretend that we're starting from a zero base
but actually to learn from the things that went well
with previous organisations and previous structures,
and the things that didn't go well.
And that's what we're doing in a different area.
It's something I meant to pick up on.
I think Jane from Birmingham and a number of people have commented
about the need for gathering information
to help you to make your case for patients.
I hope that we can do that with the new chief inspector of hospitals,
chief inspector of social care
and possibly a chief inspector of primary care,
who will go around doing very thorough, very independent inspections,
which I think will be very helpful armoury for you
when you're making the case for change locally.
But in setting up the chief inspector of hospitals,
we had the same debate over the CQC.
We had the Commission for Health Improvement,
the Commission for Health Care Assessment and Inspection,
the Health Care Commission, the CQC,
and what we've said is let's look at all of those
and let's look at why it didn't work well.
And I think, and you've hit the nail on the head,
one of the things we need is a louder patient voice.
I think we need to have a sense in which your voice rings loud and clear.
And I think, incidentally, your name is going to be a great help in that
in terms of something that journalists, reporters and broadcasters
want to comment about more.
But I think a louder and an independent and a respected voice
in the communities that you serve is going to be absolutely key.
Thanks. There's a question from Manchester
which explores the role that Healthwatch locally and nationally will have
and your own role and your own office. It goes like this.
How will Healthwatch be able to influence the decisions and policies
of the Secretary of State in the case of health and social care in England?
I hope you'll have a great influence,
because I think that my job is to be the champion of patients
and not the defender of the system.
So I'm incredibly proud of our NHS and what it stands for and its values.
But I also think that I am here to make sure that it does what it needs to do
for the people it was set up to serve, and yours is the voice of those people.
So you will certainly have a Secretary of State that listens,
but it isn't just about me.
It's actually about every single level of the NHS.
And we've had a lot of discussions about complaints procedures.
I thought what Mike said was really interesting about complaints procedures.
In too many places, complaints procedures have become about process
and the success of a complaints procedure
is, "Did we respond to someone's letter within 48 hours or five working days?",
or whatever the target is,
not, "Did we actually learn from that complaint
and change our behaviour in the hospital as a result of it?"
And the best hospitals treasure their complaints procedures like gold dust
because that is one of the best ways that they can actually learn
how to do things better.
So I think that's what we need to create throughout the whole NHS,
a hunger to learn how things can be done better.
And I think as the voice of the patients,
because I think that patients' voice has been the thing
that's not been given the emphasis that it needs to be given in the past.
I think that is where your role is going to be very important.
In terms of formalising that patient voice, that consumer voice,
will there be a code of practice
or contract for service providers and commissioners
to listen to Healthwatch feedback and action it?
Then, can they be held to account as a consequence?
This is a question from Taunton.
We can certainly consider that.
But I'm nervous about leaping into process
and formal procedures as a way of actually cracking this issue
of how we put the patient first and foremost in everything we do in the NHS.
I think this will depend much more on the relationship that you have
with the boards of your local NHS trusts, with your local CCGs,
with all the people responsible for provision locally.
And I think you have the great power of the media
and the fact that you are speaking for patients in the area you serve,
so that if they don't listen to you, they can be held to account
just in the same way that I can be held to account as a politician by the media
if I don't listen to what people are concerned about.
But I'm happy to look at whether we need strengthened codes of practice
in terms of the structures.
This is obviously just the very start of the journey,
and I think we need to keep an open mind as we go forward.
Thank you. We're in Birmingham now, metaphorically speaking.
This falls out of the Francis report that's already been alluded to
by almost everybody on the panel, and it goes like this.
Secretary of State, recommendation 146 of the Francis report
is that local authorities should be required to pass over
the centrally provided funds allocated to its Healthwatch,
while requiring the latter to account to it for its stewardship of the money.
Could you give us an assurance that this will happen,
and if we have any issues, that you'll fight our corner?
I certainly do want to fight your corner,
because I know how important what you're doing is going forward.
And we are going to look at all those Francis recommendations.
We've responded to a number of them and there are 290 in total,
so we will gradually reflect on all of them.
But let me say this.
I am aware of the fact that this is an issue in some parts of the country
where the money that was meant for Healthwatch
has been magically whittled down by the processes of government
and it's something that we want to look into carefully.
Thank you for that answer. I wouldn't be doing my job if I didn't make it clear
that there were, unsurprisingly,
a considerable number of questions about resources,
sometimes prefaced with the word "recession".
Other times, more of the line that we've just chosen one example.
Different tack now, and we're up in Manchester.
Can Healthwatch campaign on local issues?
What degree of local autonomy is there?
I think it's your job to campaign on behalf of patients,
so I don't have any problem with...
In fact, I would say that's what you're set up to be,
to be the campaigning voice of patients in the areas you represent.
Where I think you have to be careful
is because health is often a political issue as well
and there are often local politicians, local MPs,
local parliamentary candidates who are running campaigns in the health arena.
You have to be very careful to make sure
that your campaigns don't become party political,
because we want Healthwatch to be here forever,
and that means being here through successive governments,
governments of different parties and different colours,
and so I think it's important that you don't become identified
either nationally or locally with a party political campaign.
That's the dividing line. That's where most people would be anyway.
It's certainly what NHS patients would want as well.
Thank you. It's always a dangerous thing
when any politician says, "We want this to last forever."
Here is a question that is a cunning way of asking that,
but it's really more subtly about sustainability. It's from Leeds.
What assurance can you give that Healthwatch will exist long enough
to make a real difference in the context of the short lives of LINks
and Community Health Councils?
I think it's a very fair question to ask.
All I would say is that I think amongst my fellow politicians at Westminster
there is a realisation that, actually, the NHS needs stability,
and we need to avoid structural upheavals as much as we possibly can.
That doesn't mean that we aren't going to change things in the NHS.
We have to change things and we have to change structures from time to time,
but the NHS has had a lot of that structural change over recent years,
and I think we do want stability.
That's certainly the view of my party.
It's the view of the Labour Party as well.
So I think that the most important thing
is to prove that you are good at your job, at being the voice of patients.
I have every confidence that you'll do that.
Then I am very confident that Healthwatch will be here in...
I can't say 50 years or a hundred years,
but I think it'll be here for many years to come.
Just two more questions. This one is a slightly more personal one.
It comes from London. I won't embarrass whichever table it was who asked it.
It's sort of a "what keeps you awake at night" issue.
It's this. Which is the issue within the NHS
which gives you most concern day to day, and why?
I think that, if I can lay foundations
so that in every part of the NHS we can be confident that there is
a really deep-rooted culture of compassionate care,
then I will be really proud of my time as Health Secretary.
We have that in so many parts of the NHS.
But it isn't everywhere.
And there are examples where...
I talked earlier about people with dementia.
They are some of our most vulnerable older people
where they're not treated with the dignity and respect that they deserve.
We have to recognise that this is actually about finding structures
that allow frontline professionals
to be the caring people that they want to be.
It's a very big challenge in a busy NHS.
But I think it is exactly what you're all about,
which is putting the voice of the patient first,
and in this case the voice of patients
who often aren't able to speak up for themselves.
So, that, for me, is an absolutely defining issue.
We have an ageing society now, which is, I think,
if you put your head, as it were, above the parapet and look into the horizon
beyond the economic travails we currently face as a country
and you say, "What are the big societal issues
that we're going to have to come to grips with
in the next 20, 30, 40 years?", it is really about our ageing society.
And I think an ageing society should be something that we look forward to
with great excitement and optimism.
The thought of having those extra years in our lives when we can do more things,
spend more time with our family and friends, lead richer lives,
it should be a cause of great optimism.
But whether we're able to look forward to those extra years with that optimism
will depend on whether we can find a health and social care system
that treats everyone right up until the end
with the kind of dignity, respect and compassion
that we would all want for our own family and our own friends
and, indeed, for ourselves.
That is the challenge that I'm determined that the NHS rises to.
Thank you very much.
Finally, what advice would you give all the people in this room
and in the four other rooms
and, indeed, in the 152 different Healthwatches across England
as they embark now formally on this new journey?
Well, I think you have a very, very big opportunity
because inside the whole of the NHS, the 1.7 million people who work in the NHS,
who have given their lives to the NHS,
I think there is a real willingness to put patients first,
and a real understanding that this is something the NHS can do better
than it's done in the past.
I think you will find partners inside the NHS who want to work with you,
and they will cooperate with you, listen to you,
improve what they do for patients
if they feel that you're speaking with honesty and integrity
about what you're discovering in terms of the patient experience of the NHS.
I think it's really just about that honesty and that integrity
and that fearlessness in speaking up.
I think that if you can be the critical friend to the NHS in this period,
we can all look forward to a period of great progress
in this very, very important area.
(Bill) Secretary of State, thank you so much. Thank you very much.
- (applause) - Thank you, Bill.
So, thank you very much, and we're now going to open up and continue
and deepen our conversation
by bringing in colleagues from across our five different centres.
To enable them to post questions more directly to our panel,
they may be questions inspired by what the Secretary of State has said,
by things that you said earlier on in the day
and haven't had a chance to restate
or indeed things that have occurred to you
that you think have somehow been missing from our discussions.
What I'd like you to do, please,
and I'm relying on colleagues in our four other different venues to tell me,
or indeed to tell the person who's speaking to me in my ear,
I'd love you to put your hand up if you think you have a question,
if you'd like to say something or ask something in a second.
I can see we've got two or more in London, which is great.
But before we come to London I'm going to go to Manchester,
where I know there was a question earlier on.
Just in case folk have moved around or indeed they've forgotten what they said,
for the benefit of the rest of us, I'm going to repeat it.
It was from table seven in Manchester.
I'm going to pose the question and then invite another couple of questions
and then invite my colleagues on the panel to take one or other of those.
But not to feel that they have to say something every time,
just for the interest of variety and engagement.
Here's the question. How do you intend to engage young people
and ensure that they have a voice in local services?
Oh, no, I've said it, haven't I? That's silly.
Let's go to table seven and get you to put it in your own words,
please, in Manchester.
Hello, yes. The question was,
how does Healthwatch intend to engage young people
in a way that makes Healthwatch accessible to them,
and will ensure that they have the opportunity
to inform and shape their local services?
Thank you very much. Would you like to give us your name?
- Yes, it's Jane. - Thanks, Jane.
Do we have other questions there in Manchester whilst we're in Manchester?
If so, please boldly raise your hand and pass the microphone around.
I can see it moving now. I can't hear it, but I can see that it is.
When we're ready, we'll hear that. Yes, sir.
A question for Anna and the other panel members.
We're a national provider that delivers a good-quality service
and we're also members with other good-quality providers
from the independent sector of trade bodies
with the sole purpose of driving up standards.
My question is, how do you go about sharing best practice
with local Healthwatches? Will there be a platform in place
for providers like us to share what "good" looks like?
Thank you. Two questions from Manchester. Let's pause there.
Anna, would you like to take the second one first?
Then I'll see who'd like to take the first one.
This question of providing a basis for facilitated discussion
between local Healthwatch is critical to our role.
We want to do two things, really.
One is provide a space in which local Healthwatch can do that.
There's a thing in development which will be available shortly called the Hub
which we hope will be a place where local Healthwatch can talk to each other
and share good practice.
The other will be through bringing local Healthwatch together
in physical form, as it were, through regional meetings and so on.
We'll want to do that. We hope you'll do it yourselves, too.
This is not just about Healthwatch England helping you to do it.
It's about you doing it yourselves, which is hugely important.
And the third thing that we'll be doing in this respect
is drawing on what we learn about the good practice that you're establishing
and feed that back to you in guidance and so forth.
A number of different ways, but this is a central role for us.
I just want to say one other thing,
which is when we launched Healthwatch England in October,
we talked about the fact that we hoped in future it would be local Healthwatch
who was stood on platforms talking to local Healthwatch,
and that's what we began to see this morning, which is great.
- There should be much more of it. - Thank you.
Before I invite one of you to say something about young people,
can I take the opportunity...? Most of you will know her,
but Dr Katherine Rake, Chief Executive of Healthwatch England,
is on the far stage as you look at it, and she may well indeed want to comment.
She's going to speak to us later on.
Who'd like to answer the young people's question?
- Katherine? - Shall I do that,
given you've just introduced me? Thank you very much.
This is another exciting new opportunity we've got
to make sure that when we're looking at health and social care
we're also thinking about young people and children.
In terms of what you can expect from us, there's going to be a package of support
to local Healthwatch
up on our new Healthwatch England website very shortly.
We're engaging with children and young people's organisations.
We've got an expert on children and young people
in the form of Christine Lenehan on our committee,
and we've been spending time as a committee and staff
thinking about how we can make sure
we take this new responsibility really seriously.
Because this is a group, their voices are loud, but they are seldom heard.
It's a group that's absolutely critical to the health and social care services.
Thank you very much. I know you've got a distinguished background in that area.
Mike, were you trying to catch my eye?
Just to say at our last Healthwatch board meeting
we had a representative from a young people's group, which was fantastic.
It was a different perspective, and we're now talking with that individual
and those organisations about building a strategy and a plan
for young people and children.
I think one of the great things about IT and social media is that with a website,
with a Twitter account, Facebook, actually, anyone can engage with it.
I very much hope that we will be able to attract younger people and children
to engage in some of the topics and discussions that we've had,
because we need to make it relevant to them as well.
I think that will be the challenge.
I think we have to remember it's not just about adults, it's about children,
and the children who will be adults of the future.
Thank you. We're going to Taunton now, to table three.
A reminder, whilst table three is getting itself organised,
especially if we've not had from you, Leeds, Manchester, do put your hand up
and catch the eye of the facilitator in the room so that we can come to you.
Let's go to Taunton, table three, and then Taunton, table five.
Good afternoon, everybody. I'm Peter Grover,
a patient representative from a local Taunton surgery.
My question is relating to information flow.
In the past, airlines had a very bad history of killing their passengers.
Today, that no longer, fortunately, is true
and they have an excellent safety record,
which came from a change in culture
from a closeness of keeping information to themselves
to one where the obligation to report each and every incident
led to the correction of problems.
When will the NHS embark on a similar change
to bring about the statutory obligations for a more open culture,
so that, over time, the problems which have been only too obvious recently
in the press are things of the past?
Thank you very much.
A question about culture change and real behaviour change.
I think we've got another question. Table five.
Do, please, keep them short. Sir.
I'm Chris Wakefield from Healthwatch Dorset.
How will we know in two or three years' time
whether Healthwatch has been a success,
and what factors would you take into account informing that view? Thank you.
(Bill) Thank you. Victor.
Which of those or both of those would you like to have a go at?
(Victor) A couple of things.
I think on the information question,
I do know that on the board of NHS England,
some of you may know Tim Kelsey, who is passionate about transparency of data.
I think he's going to drive a real open agenda.
But my view is that what's required
is a respect for both qualitative and quantitative information
about what people experience.
One of the things that... One of the big mistakes in the past
is that we have tended to favour numbers over experience.
And any business that takes customers seriously also values experience.
And I think that's what we're going to have to do,
and we're going to have to make it totally and utterly transparent.
We get bogged down in data.
I'm much more interested in information
and I'm much more interested in experience than I am in numbers.
On the issue of what success looks like, I think it's fairly obvious.
Well, it's obvious to me.
Unless we change the way services get designed and delivered,
then we won't have succeeded.
I think we could have a chat amongst ourselves,
we could have very exciting chats amongst ourselves,
but if we're going to reverse the inverse care law
and meet the challenges of health and social care going forward,
we have to core design services differently
and we have to commission differently.
Thank you. I'm going to pause there and, just as a way of managing the process,
invite my colleagues to hold anything they didn't get a chance to answer.
Hold it up and I'll ask you a last question, which is,
what was it you wanted to say in answer to an earlier question,
but I moved on too quickly?
We're going to come to this room in London.
I think we've got a question on table 20.
I'm hoping we have a question on table 20.
Table ten we've got a question from. Table ten it be.
(woman) I don't know if this is ten.
That'll do us very nicely. Welcome. Thank you.
My name is Anita Higham and I'm from Oxfordshire Healthwatch.
Very excited by Anna Bradley's presentation.
Particularly her notion of the need to learn,
on the part of the health and social care professionals,
that it's the... to learn to speak consumer
before they start speaking about the bit of the body
that they're focusing on or whatever.
Bearing that in mind, I wonder to what extent
Healthwatch England will be able to influence all those local authorities
when, in setting up their health and well-being boards,
although they've interpreted the legislative word of a seat for the CCG
and a seat for etcetera, have held literally to Healthwatch
as only having one person there. In the case of Oxfordshire,
that one person has to represent 660,000 people.
Why is it that local authorities haven't had the confidence
to have the two or three Healthwatch representatives
that they're quite happy to have from the CCG or the primary care lot
or social care or the children's services or public health?
I would be interested to know to what extent we can encourage
local government to think a bit more creatively
and understand that concept which Anna very clearly spelt out.
- Thank you. - Thank you so much.
A challenge for creative local government.
I'm hoping that in my maths is right this time.
I'm reliably informed that table six has a question, but I may be wrong.
(woman) No, you're absolutely right. This is table six. My name is Sally.
Anna Bradley said at a meeting in the Houses of Parliament a few months ago
that Healthwatch England had identified specialised services
as being one of its priorities in the coming year.
I have heard more recently, particularly since Katherine came into post,
that that is no longer the case.
So I'd just like to know whether specialised services,
and hearing from the people who use specialised services,
is or is not a priority of Healthwatch England in its first year.
If it's not, I think that's extremely disappointing,
because they've always been a bit of a Cinderella
when it comes to organisations like LINks
and patient and public involvement forums.
Victor, please can you get NHS England to open up its board meetings a bit?
At least answer questions from members of the public at the board meeting.
It's so stultifying just sitting there listening to you talking to each other.
(Victor) You're not wrong, I get bored, too.
(Bill) We're off and running now.
Thank you. No pressure. Katherine then Victor, from the sound of it.
(Katherine) To take the point around...
Thank you for the question around specialised commissioning.
I'm sorry if I've misled you,
because specialised commissioning is absolutely on our agenda.
But what we want to do with that is make sure that we grow the expertise
through the regional networks of local Healthwatches
so that they can make the interventions where it's going to make a difference.
We've been meeting recently with NHS England at a national level,
and what's really critical is that we get local Healthwatch represented
at regional levels in order to influence specialised commissioning,
so I hope that offers you some assurance.
Thanks. It's not fair just to load it on you, Victor,
but any thoughts about that more open approach?
(Victor) I do think... This might be controversial,
but I think... You meet...
People confusing representation with influence is a mistake.
In my humble opinion, if you want to change the way in which
health and well-being boards, and indeed CCGs, operate,
you need to hold them to account for the process by which they've arrived
at the decision point.
So, what I've seen travelling the country
are various attempts to engage communities
in understanding their needs, and using that to design services.
Some of them, frankly, are pathetic. They've made their decision,
they have a church hall meeting and what comes out is unrecognisable.
I think one of the key tasks of Healthwatch, amongst others,
is to look at how have you arrived at those commissioning assumptions?
How do you understand the needs of individuals and communities
in this area? Show us how you've done it.
If that process isn't recognisable to you,
and the outcome isn't recognisable to you,
those services haven't been commissioned.
They've been purchased or procured, but they haven't been commissioned.
On the point about attending the NHS England board meetings,
I don't chair them, but I'm confident...
I think... Personally, I'm probably going to get fired for this,
but I have no problem with engagement with the public.
You're paying for it.
I think you should be engaged, but it's not my decision.
There's a board meeting tomorrow, so I'll have a word with Malcolm.
(Bill) That's very helpful.
Other panellists may want to come back on that question
in their final single remark.
We're going to Birmingham now, where we have a question on table 12.
I'm Peter Rookes and I'm chair of
the Public Engagement and Partnerships Committee of Birmingham CrossCity CCG.
I'm sure we all agree with the Secretary of State's desire
that Healthwatch should continue for some time in the future.
It's worth remembering that Community Health Councils continued for 25 years.
My question, therefore, is to do with funding.
It's my understanding that the funding that is available
is only for two or three years,
and in order for Healthwatch to move forward with confidence
and ensure future sustainability,
surely it needs not necessarily a guarantee
but some understanding that funding will be available
subsequent to that period of time. There has been a suggestion
that local Healthwatches would be required to raise their own funds.
I have a concern that that may well divert their main attention
from the focus of serving patients.
(Bill) Thank you very much for that question on funding.
We're going to Leeds now, to table one.
Thank you.
Joy Fisher speaking from Leeds LINk, hoping to become part of Healthwatch.
I've heard a lot of innovative ideas from Jeremy
and from the other colleagues at Healthwatch England.
This is a question for Anna and for Katherine.
What we haven't heard much about is social care.
I'd like to hear how we can overcome the barrier given to us
by national government of the name Healthwatch
and help the general public understand that it's health and social care,
and ensure that people can understand the system as it operates.
In Leeds we're working *** integrating systems
and we'd like to hear more from Healthwatch England
as to how it intends to make this articulation evident to the public
and help them negotiate a complex system.
Thank you so much. We've been at pains to say health, social care
and, indeed, public health, Mike was inviting us to think about earlier on.
Who'd like to take that?
(Victor) Can I? I know I've been banging on a bit. I'll shut up then.
Have a quick go, then pass to your left or right.
A, I think it's an excellent question.
It's about health and social care. There's lots of talk about integration.
My view is that you know integration when you feel it and see it
because the wire's hidden. It's a single issue.
If I was to critique the Secretary of State's contribution,
it was a bit hospital based.
It was a bit about patient-hospital, hospital-patient.
We have to move forward.
If I was to critique the question a bit, I would say
it's not about Healthwatch helping people navigate a complex system,
it's about Healthwatch saying to the system,
"Why are you complex?" Because you don't need to be.
A lot of this stuff is about people hiding behind the complexity
because it's about power.
(Bill) Katherine or Anna, one of you.
(Anna) So, I completely agree with that.
I think the answer to how people see it is in all of our hands.
We have to make sure that we are really clear with people all the time
that we're talking about health and social care.
The choice of priorities for both Healthwatch England
and for every local Healthwatch has to reflect that.
You need to be working in social care as well as in health.
I think the solution to the Healthwatch issue is in our hands.
Actually, I think the solution to the funding issue
is also probably in our hands
because what I think we're now seeing is, effectively,
all-party support for local Healthwatch and Healthwatch as a network.
And I say not just because Jeremy said it here,
but because we've talked to all parties about this issue
and we do very clearly have all-party support.
The next issue is to talk about how we make this long-term sustainable.
We'll be absolutely on that case. That's part of our role.
Thank you. We're running out of time fast.
But if there are any other questions, hands up. I can see two in London here.
I'm going to do a big sweep now, starting in a moment in Manchester.
If I could go there for table four, and then a question in this room.
If there are others, let's take them all,
and then I'll invite my colleagues, starting from this end,
to move down the line and answer one or more
or things they wanted to say earlier on. Let's go to Manchester, table four.
Good afternoon. Sue Stevenson, Healthwatch commissioner from Cumbria.
We've talked a lot today
about Healthwatch needing to raise its profile in communities
and increase the influence of people and design of delivery services.
However, in places like Cumbria,
many people have experienced services becoming more distant,
especially specialist services,
and what they want is more services to be delivered much more locally,
not least because we have a massively ageing population
and lots of challenges around travel.
What does the panel think is the role of Healthwatch in managing expectations
and helping develop a better understanding
of what an effective and efficient health and social care system
should look like and is possible, given the challenging economic situation?
(Bill) Great question, expectation management.
We're going to go to 26 here in London. Sir.
Earlier on you asked a question on behalf of many people
in relation to the finance coming down from central government.
Whether the possibility was it was going to be top sliced
by the local authorities because of their current financial difficulties.
Unfortunately, I think the Secretary of State indicated
that that was quite likely and had happened in other places.
I come from East Sussex, I'm a volunteer representative.
(Bill) I have to press you. Your question?
The finance, can the county council or local authorities
dictate any of the decisions that the corporate bodies will make
- as well as local Healthwatch? - (Bill) Thank you.
There's a colleague on the table just by you
if you pass that microphone, please.
OK.
- No? - (woman) Hi.
Yes.
I was really pleased to hear the Secretary of State saying that
all the DH are going into frontline... have frontline experiences in the NHS,
and that he went to an A&E in Watford, I think it was.
I was just thinking about Lewisham A&E and maternity services.
- Last year, as part of LINk... - (Bill) I have to press you.
- Your question? - It's very quick.
We took part in the consultation for the TSA report
and over 5,000 people were really, really concerned.
They're the people that actually marched,
but there were a lot more people that are really concerned about services
in Lewisham being downgraded.
I just wondered how, as Healthwatch, we're representing people's views,
but they don't seem to be heard by central government.
So I just wondered how we can ensure that if we are supporting local people
to have a say in local services, and are challenging local commissioners,
how can we have our voices heard nationally?
Thank you very much. I'm going to start at this end with Anna.
Invite you to take 30 seconds,
maybe taking one of those questions or remarks that you want us to remember.
Anna, I know you've got another bite at this.
Perhaps a special self-denying ordnance here. Anna.
I'll pick up one that came up earlier,
which I think was what about what success looks like.
Victor quite rightly said it's about real change
in systems and services that are delivered.
I think that's absolutely right, that's the ultimate measure,
but one of the things we'll be doing as Healthwatch England
is working with all of you
to work out what a good local Healthwatch looks like,
which is another thing I think we all need to get our heads around.
How can we know that we're all delivering the right thing
- for our consumers? - Thank you. Mike.
I think the greatest kind of challenge for our strategy
is how do you capture and reflect back the wide views of the public,
and, therefore, their voice?
But what do you then do with that voice?
(woman) Let's go ahead with what we were planning to do,
and listen to the questions coming from the room. There was...
(Bill) Thanks. Sorry. Press on. It was a voice from elsewhere.
I think for Healthwatches, it's about capturing that view
and making sure they're representative,
and then it's about doing something with that voice.
I think that will determine the success
and how people view and perceive Healthwatches.
And by making those changes and being involved in that change,
I'm very much hoping that more people will then want to become involved,
and the more people who become involved, the more legitimate
and the greater credibility local Healthwatches have.
Thank you, Mike. Victor.
I think there's two things. The first is exampled by the last statement.
I think that Healthwatch will need to be transparent and accountable
for the decisions it makes in such a way that it cannot be seen
just as standing in opposition to change.
Because change has to happen.
But it's about how that process
represents the needs of individuals and/or communities.
That's the critical issue.
The second issue for me, and I think this is really important,
it's hardly ever touched on. It was touched on
in the question about young people, but it is, which young people?
One of the problems that you're going to face
in communities up and down the country is that they've changed.
In London there are 300 languages spoken.
The challenge, I think, for Healthwatch,
if you are going to be truly representative,
is how do you engage those people that normally don't have their voices heard?
I think that's a big challenge, because unless you hear those people,
then you will not be credible. One final thing.
My organisation, Turning Point, set up something called Connected Care.
We have about 300 people out there designing services with communities.
My offer to Healthwatch is that we will share our learning with you
so that we can add value to what you need to do.
Thanks, Victor. And Katherine.
What I'm hearing from across the room is a lot of concerns, not surprisingly,
at a time of incredibly constrained resources.
We're always anxious about health and social care,
but particularly anxious when resources are constrained.
One of the things I wanted to point out is one of the new statutory powers
that we have as Healthwatch England,
which is to advise right across the system,
including to the Secretary of State.
That's something that we are going to be looking to use in this upcoming year,
both reflecting the concerns that we're hearing from local Healthwatch
about what's happening in their local communities,
but also concerns that we're picking up at a national level
about what's happening in health and social care.
So we've got that new lever to amplify concerns about the experience of users
of health and social care right across the system
and right to the Secretary of State.
Thank you so much. Just time for a few final reflective comments
from both Katherine and Anna in the reverse order.
But just before that, we lost each of the centres for a few moments there.
We're back up.
If you missed those two minutes,
then you can get the webcast from the website.
Don't feel in any way aggrieved.
Just to bring our very powerful and interesting
and questioning and challenging launch to a close,
I wonder if I could invite Anna Bradley just to give us her final reflections.
So, a couple of responses to some themes.
The first is a couple of questions about reshaping services,
or what they call in the trade reconfiguration.
I want to say that I think
local Healthwatch has an incredibly important role in these conversations.
The role of local Healthwatch is...
Victor said it already, but I want to emphasise it,
to challenge all those players to make sure that the kind of engagement
they have with their local communities is really a good-quality discussion
which allows people to come away from them
better informed than they were when they went into them
and then ensures what we all hope
will be the best outcome for those communities.
That's the first thing,
a really important role for local Healthwatch is challenging the system.
The second thing is that,
actually, this emphasis on you learning from each other.
I want to go to Anita's question about local health and well-being boards.
Quite a few of you have already ensured that you've got more than one member
on the local health and well-being board.
You need to be sharing with each other how it was you achieved that.
You know better than we know what worked
in order to persuade people to make that happen.
The third thing I just want to mention is the whole question of independence.
It comes up often, whether you're talking about Healthwatch England
in relation to CQC or local Healthwatch in relation to local authorities.
I want to say this.
The statutory basis for our collective existence requires us to be independent.
You have been commissioned as local Healthwatch to be independent.
Just take that opportunity.
There is no reason why you should be told what to do.
And so you should speak out in a way that you think is appropriate.
That's your job. If we don't do it, we won't be doing our job well.
I guess my last reflection is just to say
if I wasn't persuaded when we came into the room,
I'm persuaded even more than ever before that,
A, we've got a hugely important task,
B, there is an enormous opportunity for us to do something really different
and much better for consumers,
and C, I think we've got the right people in the room to do it.
So I look forward to working with you all.
And the right people in five rooms.
Just in case you were feeling remissed there.
(Anna) They're on the web as well.
Thank you. Katherine, your final... and your thoughts looking forward.
I think there are two things that I'm picking up from across the country.
The first is an absolutely enormous sense of excitement.
The second is a very healthy dose of fear.
One of the reasons I think we're feeling such an enormous sense of excitement
is it's a privilege to be at the birth of a new organisation.
It's a privilege to be in the rooms with people who are committed and dedicated
and passionate about the issues.
But, most importantly, it's a privilege to have been given the right
to advocate on behalf of consumers and users of health and social care.
That's why we're a little bit scared as well.
We really, really want to get this right.
We are doing that at a time where we are both creating new organisations
and having to deliver at the same time. That's where the fear comes from.
One of our jobs at Healthwatch England is to make that
as easy as we possibly can for local Healthwatch.
I just wanted to end with a little advertorial about what's to come.
I hope you've had the chance to look at our new website
and the area there that is for local Healthwatch.
There'll be information up there shortly
about how we work with children and young people.
There's information there already
about how you get set up in the best possible way,
so you're not having to reinvent the wheel 150 times across the country.
And, from Monday, there'll be a dedicated helpline number
for local Healthwatch where you'll be able to reach directly
a member of the Healthwatch England team
to raise concerns and any issues that you've got in this setup period.
So, we've got a lot on offer for you.
But it's really important that we continue to hear from you
what you need and want in these very crucial first few months.
So we're looking forward to meeting you all again
at the National Conference on June the 20th.
And the final thing I wanted to say, as Chief Executive,
is what a fantastic team we've had of Healthwatch England staff,
of local Healthwatch who've led the events this morning,
and of our committee. It's been a brilliant event
and there's been a lot of sleepless nights and very hard work.
I just wanted to say a huge thank you to the team.
Thank you. Put your hands together and thank the teams, please,
up and down the country.
Thank you, and, of course, again, would you put your hands together
and thank especially all those who took part in the morning sessions
in our five different venues?
Just a slight delay there, but I think you understood what I was trying to do.
And all of our panellists this afternoon,
if you could thank them as well.
And, most importantly, maybe you don't want to thank yourself,
but we'd like to thank you for giving up valuable time this afternoon.
Or, if you've been here for both events, this morning as well.
www.healthwatch.co.uk is the place to go to find out any more.
Before we go, I am absolutely thrilled that we can show you now,
for the first time,
a special advertisement that's been made to help you.
We hope it can be of local, regional, national use
in getting the message out there.
After this, we'll return to our venues, wherever they are.
This is a goodbye from me, too. Let's cue the advertisement.