Readers’ letters – 2 October 2014

Ombudsmen can fill the health and social care commissioning void

In the article published yesterday in on hsj.co.uk (‘Exclusive: Ombudsman seeks new powers to investigate NHS’), I was impressed by the Parliamentary and Health Service Ombudsman and Local Government Ombudsman’s recommendation that the two bodies merge into one new public sector ombudsman, which would be given new powers.

Care England is particularly supportive of the ombudsmen’s suggestion that this new body be given power to proactively evaluate the commissioning decisions of clinical commissioning groups and local authorities. As they rightly state, commissioning decisions can be causal factors behind a service failing “but don’t happen to be ones covered by the regulator in terms of safety and quality”.

‘Something has to be done about the vacuum that exists in the oversight of commissioning across both health and social care’

As is widely known, the Care Quality Commission has a new inspection regime, which we welcome for its increased rigour and the holistic approach that it takes in inspecting the care that services provide. The Care Act additionally places a range of duties on local authorities including additional responsibilities around safeguarding, assessment and market shaping.

Nowhere, however, is there either an oversight system for commissioners that reflects the rising expectations that providers are expected to conform to, or one that would indeed monitor local authorities’ performance against the duties that the Care Act will soon place upon them.

Concerns have been raised that if such a system were to exist, it would impinge upon local authorities’ sovereignty; on the contrary, we believe that it would demonstrate whether they are doing the job that their electorate put them in power to do.

Councillors representing local authorities with poor commissioning practices would be questioned on their record, while councillors who have put in place quality commissioning systems could use the judgement of an independent oversight body as evidence of their adeptness for office. More power consequently rests with the individual voter and the democratic mandate that binds local councillors and their electorates can only be stronger for that.  

Regardless of concerns put forward in relation to individual proposals, it is clear that something has to be done about the vacuum that exists in the oversight of commissioning across both health and social care, and we are encouraged by the ombudsmen’s recognition of the urgent need for that space to be filled.

Jamie Balbes, policy officer at Care England