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25th January, 2001
For immediate release
Community Health Councils' Response to
costing of new structures
Responding to the publication, in the Health Service Journal, of figures indicating that the new patient representation structures could cost as much as 5 times (see below) what is spent on CHCs Donna Covey, Director of the Association of Community Health Councils, said:
‘You would think that given this enormous increase in expenditure on patient involvement that the health community would be delighted by the government proposals. The reality is that the Secretary of State has succeeded in quadrupling the expenditure on patient involvement in the NHS, while at the same time alienating patient representatives.
‘If you are going to spend this much on patient involvement, then you ought to make sure you get it right. The worry across the health community is that the government is replacing an effective, independent local Watchdog, with a cumbersome and ineffective system, lacking in statutory powers and independence.
‘The question is: are the public getting value for money? Public money might better have been used to build on the 25 years of experience and goodwill that exists in CHCs. Instead, they are being swept aside in favour of a system that has never even been properly piloted.
‘We have argued throughout this process that no meaningful consultation has taken place, particularly on the issue of the abolition of Community Health Councils. It’s a shame the Secretary of State couldn’t match his financial commitment with a willingness to listen to the views of the health community on this issue.’
-ends-
For further information please contact: Murray Benham on - 020 7609 8138
email: murray.benham@achcew.org.uk
website: www.achcew.org.uk
THE COSTS OF THE SUCCESSOR SYSTEM TO COMMUNITY HEALTH COUNCILS IN ENGLAND
The current cost of Community Health Councils in England (including NHS overheads attributed to them) is £23 million per annum (approximately 46 pence per person per year – or just under one penny a week).
The successor system will include:-
(a) Patient Advocacy and Liaison Services (PALS)
(b) Patients’ Fora
(c) Oversight and Scrutiny Committees of Local Authorities
(d) Independent Local Health Advisory Fora (ILAF)
It is understood that £10 million will be available nationally for PALS in 2001/02 and £33 million per annum from 2002/03 onwards.
It is understood that Trusts will be expected to set aside 0.05% of their overall annual budgets for patient and public involvement. This will apply both to existing Acute and Mental Health Trusts and to Primary Care Trusts (and Care Trusts). It may apply to any Community Trusts that remain after 1 April 2002. It will not apply to any Primary Care Groups which remain (patients covered by them will not be represented in the new system) in the interim period to 1 April 2004 (when all Primary Care Groups have been succeeded by Primary Care Trusts). A reasonable estimate would be that as of 2004/05 in England this might amount to around £60 million per year (corresponding to overall Trust budgets of £120 billion per year – half for Primary Care Trusts/Care Trusts and the other half for Acute and Mental Health Trusts). In 2002/03, on the assumption that only half of the population of England was covered by Primary Care Trusts, a figure of £45 million would be reasonable (these figures imply around £90-120,000 per Patients’ Forum, compared with a notional £130,000 per Community Health Council).
There are likely to be around 200 local authorities with oversight and scrutiny powers. On the assumption that each of them would need to employ a health policy analyst and provide appropriate clerical and office support to the oversight and scrutiny committee, a baseline cost would be around £70,000 per authority per year. This implies a cost of £14 million per year.
A similar baseline estimate for the Independent Local Health Advisory Fora would suggest a baseline cost of £70,000 per Health Authority. Currently, there are 99 health authorities in England. It seems likely that the number will reduce to 60 by April 2002 and to 40 by April 2004.
There are likely to be some further costs. It is understood that local health authorities may be required to contract with specialised advocacy services as a backstop to the PALS. It is difficult to estimate how much this might cost. Tentatively, it has been taken to be the same as for the ILAF as of April 2002 but not reducing over time.
No attempt has been made to add in the indirect costs of increased resort to litigation as a result of perceived lack of independence of PALS suggested by the Law Society.
ESTIMATED DIRECT COSTS OF CHCs AND SUCCESSOR SYSTEM
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Item |
2001/02 £ Million |
2002/03 £ Million |
2003/04 £ Million |
2004/05 £ Million |
Funding Source |
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PALS |
10 |
33 |
33 |
33 |
DoH |
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Patients’ Fora |
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45 |
52.5 |
60 |
Trusts |
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Oversight and Scrutiny Committees |
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14 |
14 |
14 |
Local Authorities |
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ILAF |
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4.2 |
4.2 |
2.8 |
Health Authorities |
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Specialist Advocacy Services |
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4.2 |
4.2 |
4.2 |
Health Authorities |
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CHCs |
23 |
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DoH |
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Total Direct Costs |
33 |
100.4 |
107.9 |
114 |
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Donald Roy
11 January 2001