Agenda and minutes

The Council, at its meeting held on 18 October 2007, made appointments to the pan-London Joint Overview and Scrutiny Committee (JOSC), which had been established to consider Healthcare for London – A Framework for Action (also known as the Darzi Review).  Subsequent to these appointments, and following further discussion at the Overview and Scrutiny Committee meeting held on 13 November 2007, Councillors Mrs Rekha Shah and Mrs Margaret Davine had indicated their wish to step down from the JOSC.  It was noted that the information received from London Councils indicated that there should be one member per authority with a substitute, if necessary.

Resolved to RECOMMEND:  (to Council)

That the appointments of Councillors Mrs Rekha Shah (Adult Health and Social Care Performance Lead Member for Scrutiny) and Mrs Margaret Davine (Children and Young People Policy Lead Member for Scrutiny) as the Council’s 3^rd and 4^th Reserve representatives on the pan-London Joint Overview and Scrutiny Committee be rescinded.

(See also Minutes 208 and 218).

Having opened the meeting, the Chairman requested the Committee to observe a minute’s silence in memory of the late Councillor Mrs Janet Cowan, a former Mayor and a Member of this Committee, who had died suddenly on Saturday 27 October 2007.

Following a minute’s silence, the Chairman and the Vice?Chairman paid tribute to the work carried out by Councillor Mrs Janet Cowan and stated that she would be sorely missed by her colleagues and the people of Harrow.

To note the attendance at this meeting of any duly appointed Reserve Members.

Reserve Members may attend meetings:-

(i)                 to take the place of an ordinary Member for whom they are a reserve;

(ii)               where the ordinary Member will be absent for the whole of the meeting; and

(iii)             the meeting notes at the start of the meeting at the item ‘Reserves’ that the Reserve Member is or will be attending as a reserve;

(iv)              if a Reserve Member whose intention to attend has been noted arrives after the commencement of the meeting, then that Reserve Member can only act as a Member from the start of the next item of business on the agenda after his/her arrival.

RESOLVED: To note the attendance at this meeting of the following duly appointed Reserve Member:-

To receive declarations of personal or prejudicial interests, arising from business to be transacted at this meeting, from:

(a)               all Members of the Committee, Sub Committee, Panel or Forum;

(b)               all other Members present in any part of the room or chamber.

RESOLVED:  To note that the following interests were declared:-

Agenda items 10/11 – CNWL Mental Health NHS – Foundation Trust – Update and Benefits/Stroke Services at North West London Hospitals – Update on Developments - October 2007

The following Members indicated personal interests set out below and remained in the room to participate in the discussions and decisions relating to these items and ask questions on the presentations received at the meeting:-

(i)                   Councillor B E Gate stated that he was married to a health professional employed by the local PCT.

(ii)                 Councillor Mrs Rekha Shah, a Reserve Member of this Committee who was back?benching that evening, stated that she had been a patient at Northwick Park Hospital and that she worked for Brent Council.

Agenda  item 12 - Scrutiny Work Programme

The following Members indicated personal interests set out below and remained in the room to participate in the discussion and decision relating to this item:-

(i)                   Councillor David Ashton, who was not a Member of this Committee, stated that he served on the Mencap Fundraising Committee.

(ii)                 Councillor Barry Macleod-Cullinane, a Reserve Member of this Committee and back?benching that evening, stated that he was a member of Harrow and District Outdoor Pursuits Centre Trust and the Neighbourhood Housing Trust.

(iii)                Councillor Mrs Margaret Davine stated that she was a Council appointed member on the Management Committee of Harrow Women’s Centre, which received a grant from the Council.

(iv)                Councillor B E Gate stated that he was a Council appointed member on the Management Committee of Harrow Citizens’ Advice Bureau, a body that received a grant from the Council.

(v)                  Councillor Stanley Sheinwald stated that he served on the Council’s Grant Advisory Panel, a body that approved grants to the voluntary sector.

(vi)                Councillor Yogesh Teli stated that he was the Chairman of his localResidents’ Association.

Agenda item 14 – Healthcare for London – Joint Overview and Scrutiny Committee (JOSC)

The following Member indicated a personal interest set out below and remained in the room to participate in the discussion and decision relating to this item:-

Councillor Mrs Vina Mithani, who was a Reserve Member of this Committee and one of the Council’s representative on the pan-London JOSC, stated that she worked for a Health Protection Agency

General Interests

Councillor David Ashton, who was not a Member of this Committee, declared a general interest in that he was a Member of the Executive and that he had come to observe the work of the Overview and Scrutiny Committee.

To consider whether any of the items listed on the agenda should be considered with the press and public excluded on the grounds that it is thought likely, in view of the nature of the business to be transacted, that there would be disclosure of confidential information in breach of an obligation of confidence or of exempt information as defined in Part 1 of Schedule 12A to the Local Government Act 1972.

The Chairman re-ordered the agenda at the meeting. For clarity, business is recorded in the order set out in the agenda.

RESOLVED: That all items be considered with the press and public present.

That the minutes of the meetings held on 6 September 2007 and 25 September 2007 be taken as read and signed as a correct record.

RESOLVED: That the minutes of the meetings held on 16 September 2007 and 25 September 2007 be taken as read and signed as correct records when printed in the Council Bound Minute Volume.

[Note:  Some Members enquired about the decision of the Overview and Scrutiny Committee on the delegates appointed by this Committee to represent the Council on the pan?London Joint Overview and Scrutiny Committee, which had subsequently been overturned by the full Council meeting held on 18 October 2007.  They were of the view that the Overview and Scrutiny Committee ought to be afforded the courtesy of being informed, in writing, of the legal basis of the decision taken by Council.  The Chairman agreed that this request would be met].

(See also Recommendation I and Minute 218).

To receive questions (if any) from local residents/organisations under the provisions of Overview and Scrutiny Procedure Rule 8.

RESOLVED: To note that no public questions were put at the meeting under provisions of Overview and Scrutiny Procedure Rule 8.

To receive petitions (if any) submitted by members of the public/Councillors under the provisions of Overview and Scrutiny Procedure Rule 9.

RESOLVED: To note that no petitions were received at the meeting under the provisions of Overview and Scrutiny Procedure Rule 9.

To receive deputations (if any) under the provisions of Overview and Scrutiny Procedure Rule 10.

RESOLVED:  To note that no deputations were received at the meeting under the provisions of Overview and Scrutiny Procedure Rule 10.

(if any).

RESOLVED: To note that there were no references from Cabinet or Council.

(if any).

RESOLVED:  To note that there was no report from Lead Members.

[Note:  Prior to the consideration of the substantive business on the agenda, the Chairman welcomed Nicolay Sorensen from the Centre for Public Scrutiny as an observer to the meeting].

Presentation from the Chief Executive of the CNWL NHS Foundation Trust

The Chairman welcomed Claire Murdoch, Chief Executive of the Central and North West London (CNWL) Mental Health NHS Foundation Trust, to the meeting.

Claire Murdoch gave a presentation on the benefits of being an NHS Foundation Trust.  She updated the Committee on the types of services provided and highlighted the benefits of partnership working.  She stated that the benefits of obtaining a Foundation Trust status were immense, and highlighted the differences associated with reporting to the ‘Monitor’, a body that had been set up to audit and scrutinise Foundation Trusts.

The Committee was:-

·                     informed of the financial freedoms given to Foundation Trusts, which allowed the Trust to create a surplus, re-invest in services and secure long-term contracts.  There was also a greater scope for innovation;

·                     updated on the performance of the CNWL, which had been awarded, as part of its annual health check, an excellent rating for the quality of services provided;

·                     briefed on the results of the survey of service users in Harrow, which had been positive;

·                     informed of the recent achievements in Harrow, including the work carried out with the Asian community to improve communication;

·                     made aware of the positive experience of staff and service users as a result of the Section 75 Agreement – a creative approach to health and social care provision – signed with Harrow in May 2007.  Staff had been supported well during the transition of what was the first such Agreement of this size.

Claire Murdoch highlighted the key initiatives for 2007/08, including a proposal to create an Acute Inpatient service at Northwick Park Hospital.  She highlighted the need for all partners to better understand the health needs of the Borough, which was a key factor to effective service delivery.  She responded to questions from Members as follows:-

·                     To date, she had not noticed any disbenefits of operating as a Foundation Trust.  However, nationally there was a debate about how large deficits in the NHS would be financed at a time when Foundation Trusts were showing a surplus and whether these surpluses would be used to finance deficits elsewhere in the NHS.

·                     The Healthcare Commission continued to oversee all sectors of the NHS but the Foundation Trusts benefited from a reduction in  financial constraints, the requirement to supply frequent financial returns and governance arrangements.

·                     Mental Health Foundation Trusts were required to work closely with Local PCTs and that there was flexibility to move profit around (surpluses).  The level of service commissioned by the relevant PCT determined service provision in individual boroughs.

·                     Further information would be provided at a future meeting on Harrow’s needs, the strategy and how services in Harrow would be delivered.  Level of investment was also an issue that would benefit from further discussion.

·                     With regard to Child and Adolescent Mental Health (CAMH), Claire Murdoch noted that the PCTs financial difficulties had impacted on provision, but that the Section 75 Agreement reached with the Council meant that staff felt that capacity for undertaking assessments of Children Looked After could be improved.  ...  view the full minutes text for item 214.

Report of the Chief Executive of the NWLH NHS Trust

The Chairman welcomed Fiona Wise, Chief Executive for the North West London Hospitals (NWLH) NHS Trust, and Sarah Thompson, Interim Director for Strategic Commissioning at Brent PCT and Lead Manager for Adult Therapies, to the meeting.

Sarah Thomson highlighted the key points in the report circulated with the agenda and the challenges facing the NHS in ensuring that treatment to patients suffering from a stroke was given within a ‘window’ of 3 hours, in order to improve outcomes for patients.  She stated that the NWLH had a stroke unit, which provided rehabilitation and speech therapy.  It was intended to develop this service further and a multi-disciplinary Strategy Group had been set up to look at how the existing service could be enhanced.  Discussions with the PCT were continuing and a bid could be submitted for the provision of a stroke centre at Northwick Park and the Central Middlesex Hospitals.

Fiona Wise and Sarah Thompson responded to questions from Members as follows:-

·                     The Darzi Review was recommending a limited number of specialist stroke centres in London and that the NWLH was considering making a bid for the provision of such a centre at Northwick Park Hospital (the ‘hub’ with 24/7 provision) supported by Central Middlesex Hospital (the ‘spoke’).  Such an approach would require the Trust to have the backing of Harrow and Brent PCTs.  Fiona Wise considered that the Trust was in a strong position given its geographical location and transport connections.  In addition, the Trust already treated the highest proportion of stroke patients in London.

·                     If the ‘hub’ for stroke services were sited at Hammersmith Hospital, then consideration would need to be given to the issue of traffic and the ability to transport patients suffering from stroke and give them treatment within the crucial 3?hour ‘window’;

·                     Fiona Wise commented that care for those suffering from a stroke in London needed improving.  The Darzi Review highlighted the need to embrace advances in technology and medicine in this area. Tangible improvements could be made at Northwick Park Hospital but public education on strokes was also crucial.  The Ambulance Service was responsive and diagnosis was normally undertaken at the scene.  The patient was then taken to the most appropriate hospital rather than the nearest one.  A Member enquired as to whether the report was aspirational and whether improvements to services had taken place over recent years.  Fiona Wise responded that the potential for Northwick Park Hospital to become a ‘hub’ would deliver these improvements.

A Member stated that it would be helpful to see a network of resources in order to ensure that the provision of health was not purely focused at Northwick Park Hospital.  The provision of continuing care was also an issue for Harrow.

The Chairman thanked both Fiona Wise and Sarah Thompson for their report and responses to questions from Members.

RESOLVED:  That the report be received and noted.

Report of the Corporate Director of Strategy and Business Support

The Scrutiny Manager introduced the report, which set out the long list of projects to be considered for the Scrutiny Work Programme for the next 12?18 months following consultation with scrutiny policy and performance lead Councillors, Members of the Executive, and Service and Corporate Directors.  The report also incorporated projects that Councillors had prioritised from the Work Programme of the former Committees.

The officer informed the Committee that, since the report had been drafted, additional requests had been received for scrutiny to challenge the self-assessment as part of the IDeA Peer Review and to carry out a review of Council support to the Voluntary Sector.  She advised that it was too late for scrutiny to challenge the self?assessment, having cancelled the meeting scheduled on 30 October 2007 where this matter would have been first discussed.  There was officer capacity to carry out a review of the latter provided that the Governance of the Service Level Agreements (SLAs) project was subsumed into this review.

A lengthy discussion on the merits of reviewing the projects listed on page 33 (Table 1) of the agenda included the following points:-

·                     The request to carry out a review of Council support to the Voluntary Sector and its amalgamation with the Governance of the SLAs, including the political implications of such a review and the need to manage expectations, their respective priorities and how the reviews ought to be conducted.

·                     The need to build on the work previously carried out on the Voluntary Sector.

·                     The ability of Members to resource the reviews proposed.

·                     The need to widen the scope of Care Matters.  The Scrutiny Manager proposed that the Challenge Panel outlined in the report be undertaken initially and that Members could then consider whether to undertake further work.

·                     A request to carry out a light touch review of the Brent Birthing Centre in association with Brent Council.  A Member proposed that such activity be incorporated with the work on the Darzi Review.

Having considered the advice of the Scrutiny Manager, and in noting that not all non?Executive Members would be able to participate in the Voluntary Sector reviews because of their respective interests, it was

RESOLVED:  That (1) having considered the long list of potential projects, including the recommendations from the Chairmen and Vice-Chairmen of the Overview and Scrutiny Committee and the Performance and Finance Scrutiny Sub-Committee, the priority projects set out in paragraph 2.6 of the officer report be undertaken during the next 12?18 months, subject to the inclusion of a review of Council support to the Voluntary Sector and its amalgamation with the Governance of SLAs in Table 1 and an initial only Challenge Panel on Care Matters;

(2)  the remaining reviews on the long list be noted.

Report of the Corporate Director of Strategy and Business Support

The Committee received a report of the Corporate Director of Strategy and Business Services outlining options for appointing non-voting advisors to the Overview and Scrutiny Committee.  The Scrutiny Manager introduced the report and outlined the key points, which required Members’ consideration.

Members commented on the various aspects of the report, some of who urged caution in certain areas and suggested amendments.  They were of the view that the attendance of non?voting advisers to Committee meetings should be by invitation only, that additional meetings such as that proposed in the penultimate bullet point on page 82 of the agenda ought to be avoided and that it was important not to raise expectations.

Following advice from the Scrutiny Manager that the report contained two distinct proposals where attendance of non-voting advisers would be by invitation only and the creation of a Reference Group would help establish a structured relationship with those advisers already on the scrutiny database, and following a discussion on how the advisers would be appointed, it was

RESOLVED:  That (1) the role profile for non-voting advisers to the Overview and Scrutiny Committee, set out at Appendix 1 to the officer report, be endorsed subject to (i) the deletion of the penultimate bullet point; (ii) a rider that attendance would be by invitation only;

(2)  a pool of members be established to provide additional support to policy and performance lead scrutiny Members and to participate in the scrutiny projects, as set out at appendix 2 to the report;

(3)  officers be authorised to pursue the appointment of the non-voting advisers and report back to the Committee with proposed nominations for approval;

(4)  officers be authorised to develop more detailed proposals for the establishment of the pool of community representatives.

Oral report of the Corporate Director of Strategy and Business Support

Further to Recommendation I, Councillor Mrs Vina Mithani, in her capacity as the Council’s 1^st Reserve representative on the pan-London JOSC in the absence of Councillor Myra Michael, the Council’s main representative on this body, provided a feedback from the first informal meeting of the JOSC held on 30 October 2007 and how it would operate in the future.

The Councillor also briefed Members of the Committee on the Darzi Scrutiny Working Group, which had met on 12 November 2007, including its terms of reference.  In the absence of Councillor Myra Michael, Councillor Vina Mithani had assumed the Chair at that meeting.  The Working Group would next meet on 17 December 2007. Councillor Barry Macleod-Cullinane, the Council’s 2^nd Reserve representative on the JOSC, reported that the Working Group would take issues forward and feed these in to the pan-London JOSC.

Members of the Committee sought clarification on the workings of JOSC, including its membership.  Some Members were of the view that the Council’s representation on the JOSC – one Member per authority with a substitute – ought to be non-political.

The Chairman thanked Councillor Vina Mithani for the briefings.

RESOLVED:  That the briefings be noted.

Which the Chairman has decided is urgent and cannot otherwise be dealt with.

The Chairman reminded Members of the subject-specific Member Development Session for all Members serving on the Overview and Scrutiny Committee and its Sub-Committees scheduled to be held on 15 November 2007 from 7.00 pm until 9.00 pm.

RESOLVED: That the above be noted.

In accordance with the provisions of Overview and Scrutiny Procedure Rule 6.7(ii)(b), it was

RESOLVED: (1)  At 10.00 pm to continue until 10.30 pm;

(2)  at 10.30 pm to continue until 10.35 pm.