Proposals to update local accountability have been put forward as part of a consultation on regulations governing Local Authority Health Scrutiny. The current arrangements need to take account of the new structural changes created by the reforms and the introduction of CCGs Health and Wellbeing Boards and HealthWatch.
The 26-page DH consultation focuses on how disputes over service reconfiguration plans are handled by local authorities once they take over public health budgets from April 2013.
Under the proposals local authorities could be required to consider the financial implications of any service changes and to publish a timescale for deciding whether to refer a proposal for service reconfiguration they disagree with to the health secretary.
The consultation also proposes an 'intermediate' mechanism that would allow local authorities to refer a disputed proposal to the NHSCB and asks whether the consent of the full council should be required before any commissioning decision is referred either to the health secretary or NHSCB. However respondents to the consultation are asked if the first referral stage of a dispute should go to the NHSCB before it reaches the health secretary the DH says it does not intend to remove a local authority's power of referral to the secretary of state.
Under the plans local authorities will be able to draw up their own proposals for service reconfiguration if they believe the existing ones are not in 'the best interests of the local health services'.
The consultation adds that it 'may be difficult for the NHSCB to both support CCGs with the early development of reconfiguration proposals (where CCGs request this support) and also to be able to act sufficiently independently if asked at a later date by a local authority to review those same plans'.
We will of course let you know when the DH publishes its summary of the responses and keep you informed of the substantive changes when they are announced.