SUMMARY/PURPOSE

1. To propose the establishment of a joint health scrutiny committee with Southampton City, Portsmouth City and Hampshire County Councils.

2. In creating the joint committee to disapply the requirement for proportionality under Section 15 of the Local Government and Housing Acts 1989.

BACKGROUND

3. The combined effect of Section 21 of the Local Government Act 2000, Section 38 of the Health and Social Care Act 2001, the Local Authority (Overview and Scrutiny Committee Health Scrutiny Functions) Regulations 2002 and associated statutory guidance is that, where a proposal by an NHS body to substantially vary or develop health services which affect more than one local authority, those authorities shall jointly create a single health scrutiny committee.

4. The terms of reference (described as a protocol) attached as appendix 1 have been agreed by the four local authorities most likely to be affected by such NHS proposals within the sub-region.

5. The intention is that the joint committee being proposed would serve two functions:-

· To co-ordinate and influence the exercise of health scrutiny collectively and individually by the joining authorities and through sharing information, good practice and expertise to increase the profile and utility of health scrutiny.

· Where a proposal affects all four of the authorities to discharge the functions of health scrutiny under the two Acts and Regulations.

7. The joint committee would not exercise health scrutiny functions in relation to proposals which affected only two or three of the joining authorities. In such circumstances the two or three authorities so affected would form a task and finish joint select committee.

8. As a committee of the four Councils, under Section 102 of the Local Government Act 1972 the requirement for political proportionality under Section 15 of the Local Government and Housing Act 1989 applies. It is considered by the four Authorities that applying the proportionality rules would be unnecessarily restrictive in terms of each authority being able to appoint members who have an interest and/or expertise in health issues without regard to their political affiliation. Further, applying the rules of proportionality across the four Authorities is technically difficult and, by adding to the bureaucratic burden of creating and maintaining a proportionate committee has the potential to distract from the undertaking of the health scrutiny function. It is, therefore, proposed that the requirement for political proportionality be disapplied. This would mean that the Isle of Wight Council could appoint any members it chooses to the joint committee.

STRATEGIC CONTEXT

6. Health scrutiny has the ability to influence the planning and delivery of NHS services. In so doing it is a significant opportunity to assist in the delivery of two of the Council’s key objectives - improving health, housing and the quality of life for all; creating safe and crime-free communities.

CONSULTATION

7. Consultation has been limited to negotiations between the four joining authorities. The aspirations of each authority are rather different and, although Hampshire County and Portsmouth City Councils have established a mechanism for delivering a joint committee, and have endorsed the protocol included in the appendix, Southampton City Council has yet to formally signify its intention to join the committee, and if so on what terms. Informally, that Authority is committed to joining.

8. Given the degree of uncertainty which still remains it is suggested that the Chief Executive Officer be given a specific delegation to make such changes to the nature and extent of the delegations to the joint committee as are necessary to give effect to it.

9. At its July meeting the Social Services, Housing and Benefits Select Committee supported the principle of a joint committee and endorsed the proposal that this Authority have two representatives on that joint committee.

FINANCIAL/BUDGET IMPLICATIONS

10. Agreement has not been reached as to how the work of the joint committee will be funded. In any event any additional costs which fall to the Isle of Wight Council will be met from within existing budgets made available for Select Committee purposes.

LEGAL IMPLICATIONS

11. The relevant legal provisions are identified in the body of the report. For the Authority to disapply the requirement for political proportionality the resolution must be passed without any member voting against.

OPTIONS

(i) With effect from 1 January 2004, to delegate the functions of health scrutiny to the proposed joint health scrutiny committee.

(ii) To delegate to the Chief Executive Officer the power to make any changes to the terms and nature of the delegation to a joint health scrutiny committee as are necessary to give effect to that committee.

(iii) To delay a decision on forming a joint committee until further negotiations have taken place.

(iv) Not to form a joint health scrutiny committee.

EVALUATION/RISK MANAGEMENT

12. The effects of the statutory provisions and statutory guidance is that a joint health scrutiny committee should be created. Not forming such a committee is not, therefore, a realistic option.

13. It would be possible to delay the creation of a joint committee until such time as further negotiations have taken place. To do so would ensure that all four authorities had, sofar as is possible, a formal shared vision for the nature and priorities of a joint committee. This would entail delay at a time when the HealthFit consultation process is at a vital stage. This delay may be prejudicial to the joint scrutiny of that particular proposal by the four authorities.

RECOMMENDATIONS

14. It is recommended that options (i)-(iii) be approved.

BACKGROUND PAPERS

15. Overview and scrutiny of health - guidance from the Department of Health.

16. Report to Hampshire County Council Health Overview and Scrutiny Panel - October 2003.

17. Report to Portsmouth City Council Health Service Overview/Scrutiny Committee - 15 January 2003.

ADDITIONAL INFORMATION

18. None.

Contact Point : Alistair Drain, ( 823801, e-mail: [email protected]

John Lawson, ( 823216, e-mail: [email protected]

MIKE FISHER

Chief Executive Officer

SHIRLEY SMART

Leader of the Council

IAN STEPHENS

Chairman of the Social Services, Housing and Benefits Select Committee

APPENDIX

HAMPSHIRE, SOUTHAMPTON, PORTSMOUTH AND ISLE OF WIGHT HEALTH SCRUTINY JOINT COMMITTEE PROTOCOL

1. Membership

(1) The Joint Committee shall be made up of 11 members comprising of :-

(1) 5 elected representatives from Hampshire County Council to include one District Councilor co-opted to that Authority’s overview and scrutiny Committee dealing with Health;

(2) 2 elected representatives from Southampton City Council;

(3) 2 elected representatives from Portsmouth City Council;

(4) 2 elected representatives from Isle of Wight Council.

The appointment of such representatives shall be solely at the discretion of each Authority who shall also waive the requirements for the Joint Committee to be based upon political proportionality.

2. Role and Function of the Joint Committee

(1) To facilitate the exchange of information about planned health scrutiny work by each member authority and to share information and outcomes from local health scrutiny reviews.

(2) To undertake scrutiny reviews of regional health services where all members are affected.

(3) To review regional or specialist services that impact on residents of the member authorities.

(4) To review health services provided for residents of member authorities outside the area covered.

(5) To work in partnership with other relevant organisations to improve the delivery of health services, improvement in the health of residents and to tackle health inequalities.

(6) The Joint Committee will not discuss individual complaints about health service provision but may scrutinise trends in complaints where these are believed to be a cause for concern.

3. Substantial Variations and Developments

A substantial variation or development is where any proposal by a NHS Body impacts on more than one of the constituent authorities area and relates to any amendment to health service delivery involving:

(1) additional expenditure or a reduction in expenditure exceeding £250,000 in any one year on any individual element or function to which that decision relates; or

(2) If it is significant in terms of any individual service element provided for the patients, carers and public who use or have a potential to use the service; or

(3) impacts on a vulnerable section of the community without adequate measures taken to assist with accessing alternative provision.

4. Co-optees

The Joint Committee shall be entitled to co-opt any non voting person as it thinks fit appropriate to assist in its debate on any relevant topic.

5. Meetings of the Joint Committee

The Joint Committee shall meet on a quarterly basis. In addition, extraordinary meetings may be called from time to time as and when appropriate. A meeting may be called by the Chairman of the Joint Committee, if he/she considers it necessary or appropriate after receiving advice from relevant officers.

Meetings shall be held at appropriate venues in the areas of the member authorities on a rotational basis.

Meetings shall be open to the public and press in accordance with the Access to Information requirements

6. Quorum

The quorum for the Joint Committee shall be 6 voting members (This ensures that there will always be a minimum of two authorities represented).

7. Chairman and Vice Chairman

The Chairman and Vice Chairman of the Joint Committee shall be appointed by the Joint Committee at its initial meeting and then on an annual basis thereafter.

If the Chairman and Vice Chairman is not present, the remaining members of the Joint Committee shall elect a Chairman for that meeting.

8. Deputies

An Authority may appoint a named deputy to attend in the place of the named member on the Joint Committee provided that the relevant officer is notified prior to the commencement of the meeting.

9. Agenda items

Any member of the Joint Committee shall be entitled to give notice to the relevant Officer that he/she wishes an item relevant to the functions of the Joint Committee to be included on the agenda for the next available meeting. On receipt of such a request the relevant Officer will ensure that it is included on the next available agenda.

10. Notice and Summons to Meetings

The relevant Officer will give notice to all members of meetings. At least 10 working days before a meeting the relevant officer will send a summons to every member specifying the date, time and place of each meeting and specify the business to be transacted, and will be accompanied by such reports as are available.

11. Reports from the Joint Committee

Once it has formed recommendations the Joint Committee will prepare a formal report and submit it to the Department of Health for consideration.

If consensus is not reached within the Joint Committee a minority report can be produced, on an alternative view to the majority of the Joint Committee, where a minimum of 4 voting members request this after the item has been debated.

12. Rights of Joint Committee members to documents

In addition to their rights as Councillors, members of the Joint Committee have the additional right to documents, and to notice of meetings.

13. Officers of Health Authorities attending meetings

(1) The Joint Committee may scrutinise and review decisions made or actions taken in connection with the discharge of Health functions falling within its remit. As well as reviewing documentation, in fulfilling the scrutiny role, it may require any officer of the relevant Health Authority to attend before it to explain in relation to matters within their remit :

(1) any particular decision or series of decisions;

(2) the extent to which the actions taken affect Council’s policy; and/or

(3) their performance.

and it is the duty of those persons to attend if so required.

(2) Where any officer is required to attend a Joint Committee under this provision, the Chairman of that Joint Committee will inform the relevant Officer. The relevant Officer shall inform the officer in writing giving at least 10 working days notice of the meeting at which he/she is required to attend. The notice will state the nature of the item on which he/she is required to attend to give account and whether any papers are required to be produced for the Joint Committee. Where the account to be given to the Joint Committee will require the production of a report, then the officer concerned will be given 10 working days to allow for preparation of that documentation.

(3) Where, in exceptional circumstances, the officer is unable to attend on the required date, then the Joint Committee shall in consultation with the officer arrange an alternative date for attendance.

14. Attendance by others

The Joint Committee may invite people other than those people referred to in paragraph 1 above to address it, discuss issues of local concern and/or answer questions. It may for example wish to hear from residents, stakeholders and members and officers in other parts of the public sector and shall invite such people to attend.

The Joint Committee shall permit a representative of any other authority or organisation to attend meetings as an observer.

15. Procedure at Joint Committee meetings

(1) The Joint Committee shall consider the following business:

(1) minutes of the last meeting;

(2) declarations of interest;

(3) any urgent item of business which is not included on an agenda but the Chairman, after consultation with the relevant officer, agrees should be raised;

(4) the business otherwise set out on the agenda for the meeting;

(2) Where the Select Committee conducts investigations (eg with a view to policy development), the committee may also ask people to attend to give evidence at committee meetings which are to be conducted in accordance with the following principles:

(1) that the investigation be conducted fairly and all members of the committee be given the opportunity to ask questions of attendees, and to contribute and speak;

(2) that those assisting the committee by giving evidence be treated with respect and courtesy; and

(3) that the investigation be conducted so as to maximise the efficiency of the investigation or analysis.

(3) Following any investigation or review, the Committee shall prepare a report, for submission to the Department of Health and/or Council as appropriate and shall make its report and findings public.

16. Administration of the Joint Committee

Hampshire County Council will provide the lead administrative support to the Joint Committee. The costs associated with this shall be shared on an equal basis amongst the member authorities.

17. Voting

Any matter will be decided by a simple majority of those members voting and present in the room at the time the motion was put. This will be by a show of hands, or if no dissent, by the affirmation of the meeting.

If there are equal votes for and against, the Chairman will have a second or casting vote. There will be no restriction on how the Chairman chooses to exercise a casting vote.

18. Public and Press

All meetings of the Joint Committee shall be open to the public and press unless an appropriate resolution is passed in accordance with the provisions of Schedule 12A of the Local Government Act or Schedule 1 of the Health and Social Care Act 2001.

All agendas and papers considered by the Joint Committee shall be made available for inspection at all the constituent authorities offices, libraries and web sites.

19. Code of Conduct

Members of the Joint Committee must comply with the Code of Conduct applicable to Councillors under the Local Government Act 2000.