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Change in the NHS
22/10/2007
The Scottish Government's plan to introduce independent scrutiny of proposals for major changes in local NHS services was put out for consultation today.
The paper sets out key principles for independent scrutiny including:
- a presumption against centralisation
- a rigorous and robust examination of the evidence for service change
- a need to identify that a full range of options are considered and examined
Cabinet Secretary for Health and Wellbeing Nicola Sturgeon said:
"It is important that we consult on the future arrangements for independent scrutiny and this paper will allow us to gather opinions on the best way forward.
"Independent scrutiny will operate prior to public consultation on proposals for major service change and the conclusions will be reported to NHS Boards and Ministers.
"In considering proposals for major service change that come to Ministers for a final decision in the future, we will look at each case on its merits but will operate a general presumption against centralisation of services.
"This does not mean that there will be no changes to health services in the future but that any NHS board that submits proposals for service reconfiguration must persuade me that their case is robust, that all possible alternatives have been considered, and that due weight has been given to both patient need and public opinion.
"Responsibility for decision making and accountability will still rest with Boards and Ministers but the independent scrutiny should go some way to improving public confidence in the process where significant service changes are being considered.
"I want to see a process that will probe any proposals for change whilst taking into account that the NHS is a public service used by and paid for by the public and as such their opinion is important. Health Boards must also show that they have considered clinical quality, sustainability, patient safety, high quality standards of care and value for money.
"Independent scrutiny will have a critical role in ensuring that the balance between clinical standards, financial performance and public opinion is properly struck. That is why we are publishing this consultation paper to help us to identify the best method of independent scrutiny to take forward."
The consultation on independent scrutiny puts forward a number of options for consideration:
- a decision conference with an independent moderator
- a scrutiny body such as a local authority
- an independent panel
The preferred option is an independent panel which is thought to be the best option for delivering a truly transparent and vigorous examination of all the evidence relating to major service change.
The paper also examines how the scrutiny panel will operate in the context of existing public engagement and involvement processes. Revised guidance on public engagement and involvement, taking into account the Scottish Government's community engagement standards is also included as part of the consultation.
The closing date is Friday January 25, 2008.