What now for deprivations of liberty?
What will the effect of the postponement of the Liberty Protections Safeguards be on local authorities? Local Government Lawyer asked 50 adult social care lawyers for their views on the potential consequences.
SPOTLIGHT |
SPOTLIGHT |
Olwen Dutton and Peter Keith-Lucas consider the lessons for local authorities arising out of the Mid Staffordshire NHS Inquiry report.
It would be easy for local authorities to dismiss the findings and recommendations of the Mid Staffordshire report as an NHS problem. But the failure to resolve allegations of abuse in local authority children’s homes for more than 30 years, the recent Banstead care death and Robert Francis QC’s direct criticisms of local authority scrutiny of health services demonstrate that this is also very much a local authority problem.
The issues for local authorities can be split between:
Effective scrutiny of health services
Robert Francis QC finds that the local authority scrutiny of health functions simply failed to identify or to address the issues at Mid Staffordshire. The key features which he identified include:
Robert Francis QC particularly recommends that complaints and incidents should be reviewed on a regular basis by the hospital’s governors and reported to the local authority scrutiny committees.
It would be fair to add the frequency of new legislation re-structuring the arrangements for the external scrutiny and supervision of the NHS, creating (and frequently abolishing) Patients’ Forums, LINks, Health Scrutiny Committees and Health and Wellbeing Boards, without a clear map of the respective responsibilities of each body, and the reluctance of the hospital to open itself to external visitors and scrutiny.
Against that background, it is unsurprising that Robert Francis QC found that the public and the hospital’s staff lacked confidence in the ability of external organisations to effectively regulate and manage health services. The system failed to detect and act upon the deficiencies of the hospital in a timely and effective manner. There is a genuine public concern that the present system of regulation cannot ensure that no such situations re-occur. So he concludes that there is a need for an independent examination of the operation of each commissioning, supervising and regulatory body, including Health OSCs, with respect to their monitoring function and capacity to identify hospitals failing to provide safe care.
Preventing care failings in local authority care services
Local authorities are not just scrutineers of NHS services. They are also major commissioners and providers of adult and child care services in their own right. And there are structural reasons why they might be even more prone than the NHS to the failings revealed at Mid Staffordshire:
In conclusion, local authorities have unique powers to scrutinise NHS functions, to call for information and explanations, to question proposed plans, and to invite senior managers to attend and provide evidence. However unwelcome their attentions may be, they do have a responsibility to exercise these powers “positively and proactively”, and that includes recognising that the function goes beyond the occasional attention of well-intentioned but lay members, to include demanding the information and providing the professional resource and competence to be able to do the job effectively.
Olwen Dutton and Peter Keith-Lucas are partners at Bevan Brittan. Olwen can be reached on 0870 194 5006 and by This email address is being protected from spambots. You need JavaScript enabled to view it., while Peter can be contacted on 0870 194 1741 and by This email address is being protected from spambots. You need JavaScript enabled to view it..
This article is part of a series of reports by Bevan Brittan on the implications of the Francis Report. For further information, click here.