What has the Independent Mayor got to hide?

The Advertiser this evening has covered an odd experience I had last night:  
Every borough has to set up a health and wellbeing board as a part of Andrew Lansley’s top down reorganisation of the NHS.  When ours was set up, through a decision of the Independent Mayor in his cabinet meeting of August 2011, it was agreed that the chair of the borough’s health scrutiny committee – me – would attend and speak.  I turned up at my first meeting in October 2011.  I was even on the agenda.  I thanked the Mayor for his commitment to effective scrutiny and transparency. 
I then didn’t get told about the second meeting.  I asked about this, and was told that the Mayor would invite me if he wanted to.  I pointed out to quite a range of people that this wasn’t quite right, as the Mayor’s own cabinet decision still stood, enshrined in the terms of reference of the board.  I believed this to have been resolved as I was invited to attend the next meeting, in March.      
Last night, when I turned up, I was asked by someone who told me he was acting on behalf of the Mayor to leave the room just before the meeting for a “quick chat”.  The upshot of this chat was that I would not be able to re enter the room, because the Mayor didn’t want me there. 
The Health and Wellbeing board currently operates in shadow form – it will become a statutory body next year.  In reality it is where the power to shape our NHS and social care services already sits.  Health scrutiny exists to ensure that those exercising those substantial powers are held to account. 
There were numerous hugely important issues on the agenda for that meeting, including an increase in waiting times for cancer treatment in Tower Hamlets. 
The NHS is under pressure.  This Tory led government wasted £3.8 million in 2010 – 2011 making NHS staff redundant in Tower Hamlets.  The cracks are now beginning to show.   Local people are now waiting longer for their cancer care.  Information from Barts tabled at the meeting, which is also publicly available, shows that in 2010/2011 93.3% of patients were treated within 62 days of their cancer screening.  This has now dropped to 79.7 for 2011/2012. This means that the Trust’s own targets are now being missed. I wanted to attend this meeting because I wanted to raise that and a number of other concerns on behalf of the residents of Tower Hamlets.    
I don’t know why the Independent Mayor agreed to my attending these meetings in August 2011 and has now changed his mind, but I am really concerned about what it means for democracy and transparency in Tower Hamlets.  When the Mayor ignores rules he set out himself, it is difficult to trust that the council is being run properly.  When elected councillors are unable to ask questions about why our cancer treatment times are going up, public confidence will suffer. 
What has the Mayor got to hide? 
Back up info: 
·         The Health and Wellbeing Board was set up through a Cabinet decision of the London Borough of Tower Hamlets in August 2011. 
                Cabinet decision stated:  
6.12. HWBB/Health Scrutiny Committee; It is acknowledged that a protocol will need to be developed covering the roles and relationship between Health Scrutiny and the HWBB. However to ensure clear and strong communication between them from the outset, it is proposed that the Chair of Health Scrutiny attends HWBB to report on Health Scrutiny activities and to comment on reports on the HWBB agenda, in a similar role to that already operating between Cabinet and the Chair of OSC.
No subsequent cabinet or mayoral decision has been published to reverse or alter this decision. 
·         The Health and Wellbeing Board brings together senior representatives from the Local Authority and NHS, with acute and primary care represented. When the board was set up in August 2011 it was agreed that the chair of Health Scrutiny would attend and speak. Cllr Saunders attended the first meeting of the board in October 2011, and a  subsequent meeting in March 2012.  
·         In response to a Parliamentary Question, the Government revealed that the NHS has spent £169 million on making staff redundant in the year 2010-11, with £3.8 of that in Tower Hamlets. (Hansard, 20 Feb 2012 : Column 713W) http://www.theyworkforyou.com/wrans/?id=2012-02-20d.95613.h&s=andy+burnham#g95613.q0
·         The Joint Health and Social Care scorecard shows that in 2010/2011 93.3% of patients were treated within 62 days of their cancer screening.  This has now dropped to 79.7 for 2011/2012. The trust’s target is 85%. 

Beyond the Bill

Below is the text of an article which was first published here on the Progress website. 

Ed Miliband has made clear that a key reason to vote Labour in local elections this May is because Labour councillors will protect local NHS services. This is a real opportunity for us to demonstrate Labour values in practice.

Like local Labour parties across the country, we in Tower Hamlets campaigned hard against the health and social care bill. We were more unusual in that our GPs also spoke out against the bill, with the chair of our clinical commissioning group Sam Everington writing to David Cameron to express the group’s opposition to the legislation. Having united in opposition to the bill, we are now finding a way through this new environment. 

One of the first local challenges was to keep as much as possible of the well-respected expertise of the Tower Hamlets PCT. The East London and the City cluster commissioning support organisation retains strong Tower Hamlets links, and our GPs are working together, with a democratic structure for the CCG and a determination to maintain a public service ethos in commissioning.  This structure is more fragile than the previous PCT and trust and collaboration across Hackney, Newham, Tower Hamlets and the City will be necessary to maintain it successfully. 

Trust and collaboration will also now be needed to fill the gaps left as the Tories dismantle our local NHS institutions. One example of this is in Bart’s and the London NHS Trust, where consultants are moving beyond the limits of their formal roles in hospitals to take a lead in tackling public health issues across the borough. 

The health and wellbeing boards, hosted by local authorities with membership from local government, acute trusts and GPs, are the formal structure around which new relationships will develop. One of their first major tasks will be to oversee the move of public health functions into local government. 

Tower Hamlets’ educational attainment rose dramatically over the period of Labour government, as increases in investment were matched by increases in aspiration and commitment from families and schools. Our children are brilliant and so are our schools – we should be among the best in the country. One reason we’re not is poor health and lifestyle. If local councillors, parents and governors had school by school health outcome statistics and some good examples of where healthy meals, exercise, early immunisation and other interventions had had an impact, we might start to see change. The Marmot review tells us that tackling inequalities doesn’t mean putting all resource where there is the greatest need – improving health outcomes in all our schools is the best way of tackling the worst symptoms of poverty and housing overcrowding. 

This period of change is an opportunity to inject greater local democracy into health structures. The late amendments to the health and social care bill, weakening the role of HealthWatch, are a major concern, and it is down to local authorities to commission in a way that supports a strong coherent local voice. Our CCG is organised democratically, and councillors will be organising democratically to influence its decisions. 

Cuts and the unnecessary top-down reorganisation imposed by David Cameron mean that we are having to spend significant time and energy on steadying structures which would be better spent improving services. The challenge now is how we as councillors work with GPs and health professionals to deliver a stronger, more responsive health service. In Tower Hamlets we have an excellent starting point – our GPs and other health professionals choose to continue to base their work on cooperation, goodwill and equality, despite this Tory-led government.