Concerns raised over new health boards and councillors seek safeguards

From July 1, 2022, subject to legislation, Integrated Care Boards (ICBs) will take on the commissioning responsibilities of Clinical Commissioning Groups and lead the integration of health and care services across their area.

Governance lead for West Yorkshire and Harrogate Health and Care Partnership, Stephen Gregg said implementation of the new system had been delayed by three months to July.

“It is clear we are aiming to be inclusive, transparent and most decisions on funding and care will be taken in communities closest to those decisions,” he said.

Decision-making of the new ICB would be held in public and there were also plans in place for a “citzens’ panel” and elected members should be involved in this.

There were no plans to have private healthcare providers on the board, Mr Gregg told members of West Yorkshire Joint Overview and Scrutiny Committee.

The meeting had begun by representatives of Calderdale and Kirklees Dial 999 For The NHS campaign groups expressing their doubts in the public question time.

They posed the question would the ICB constitution protect health services from “threats” to a universal, comprehensive NHS, free at the point of use, publicly provided, funded and based on a patient’s need and came up with the answer “not really.”

Coun Graham Latty (Leeds Council, Conservative, Guiseley and Rawdon) was worried about the sheer size of the board.

Calderdale Coun Colin Hutchinson (Lab, Skircoat) welcomed the latest strategy document’s commitment to promoting comprehensive healthcare as one of the board’s objectives.

But he could not see anything in the document that ensured, for example, that someone travelling from outside their board area to another would have their healthcare needs met.

Partnership Director Ian Holmes it would help to be explicit this would be the case.

Coun Hutchinson, asking about arrangements at “place” level, said it also seemed there was potential for a lot of confusion about who does what, it seeming health and well being boards would be the driver.

Mr Gregg said strategy would be set by health and wellbeing boards, delivered through the ICB and place-based committees who would take decisions at community level in commissioning services.

Kirklees councillor Coun Liz Smaje (Con, Birstall and Birkenshaw) asked: “Healthcare will be freely available to anyone who needs healthcare, wherever they are, yes or no?” and was told “yes”.

The issue also concerned Coun Kevin Swift (Wakefield Council, Lab, Lupset and Thornes) and he also wanted to know how much autonomy the “place” committees would have.

“There’s a distinction between which important decisions are made at West Yorkshire level and those which are fully delegated with budgets to place committees,” he said.

Mr Holmes admitted some things had been muddied with the language.

Coun Betty Rhodes (Wakefield Council, Lab, Wakefield North) said everybody seemed to be forgetting that, since the 1940s, it was a national health service and terminology should not be “the intention is” – “it should be a policy document that says ‘we will’.

“It’s not Confucius, it’s confusion,” she said.

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