To receive apologies for absence.

Apologies were received from Councillor P.E. Harling.

To receive details of any Member nominated to attend the meeting in place of a Member of the Committee.

There were no named substitutes.

To receive any declarations of interest by Members in respect of items on this agenda.

There were no declarations of Interest.

To approve and sign the Minutes of the meeting held on 8th December, 2005.

RESOLVED: That the Minutes of the meeting held on 8th December, 2005 be confirmed as a correct record and signed by the Chairman, subject to noting that  Mr J Wilkinson and Mrs A Stoakes had been present at the meeting.

To consider suggestions from members of the public on issues the Committee could scrutinise in the future.

There were no suggestions.

To consider the Director of Public Health’s Annual Report 2004/05.

The Committee considered the Director of Public Health’s Annual Report 2004/05.

Dr Frances Howie, Associate Director of Public Health attended the meeting to present the Annual Report and to answer questions, together with Mr Simon Hairsnape, Deputy Chief Executive of the Primary Care Trust.

Dr Howie gave a presentation on the report reminding the Committee that the Director of Public Health was statutorily required to produce an independent Annual Report on health in Herefordshire.

Her report focused on priorities in the White Paper published at the end of 2004: Choosing Health.  She commented in turn on each of the following priority areas: smoking, sensible drinking, mental health and well-being and obesity and the recommendations made in the Annual Report in these areas. 

Health Inequalities had been identified as a theme in its own right.  She outlined the inequalities between geographic areas in the County, in particular the inequalities in the South Wye Area, the inequalities between social groups and between households and what factors should be taken into account in devising interventions to limit these inequalities.  She drew particular attention to the poor dental health in Herefordshire and the potential benefits of fluoridation and to the continuing need to increase MMR immunisation rates.

In conclusion she stated that Herefordshire was healthy relative to the rest of the Country.  However, health inequalities did exist which action could be taken to narrow.   Long-term health improvement could be achieved by implementing the health prevention agenda set out in the Choosing Health White Paper, focusing both on both prevention and improvement.  She noted the extent to which delivery of the White Paper relied on Joint Working between Health Services and the Local Authority in particular.

Mr Hairsnape commented on the importance of the Annual Report in informing the strategic decision making of the Primary Care Trust.  The Trust’s approach had to be driven in large part by National Targets and where Government chose to direct its funding.  However, the aim each year was that the Annual Report would be produced in time for its findings and recommendations to feed into discussions on commissioning and be built into the Local Delivery Plan.  One of the difficulties was that success could not be measured in the short term.  However, whilst the emphasis might change, the key issues such as the benefits of reducing smoking did not.  He too emphasised the role of partners of the health service, in particular the Council in implementing the public health agenda.

The Director of Children’s Services reinforced the importance of the links between partners and the extent to which the public health agenda was a joint agenda.

The Committee then questioned Dr Howie and Mr Hairsnape on the report.  The following principal points were made:

·          The Annual Report had identified that Herefordshire had the lowest percentage of 5 year olds in the West Midlands (South) Strategic Health Authority Area free from tooth decay.  The Committee was advised of the effectiveness of fluoridation in reducing dental health inequalities and that an  ...  view the full minutes text for item 35.

To give further consideration to proposed changes to the configuration of the local health service. 

The Committee gave further consideration to proposed changes to the configuration of the local Health Service.

In September 2005 the Committee had endorsed a joint response by the Leader of the Council and the Committee’s Chairman to an initial exercise conducted by the West Midlands (South) Strategic Health Authority on reconfiguration of services.  The SHA had been required to submit a proposal to the Department of Health in October 2005.  Following consideration by that Department consultation papers on proposals for the future organisation of the NHS in the West Midlands had been issued in December 2005.

As part of the consultation exercise representatives of the West Midlands (South) Strategic Health Authority (SHA) had asked to address the Committee.

The following representatives of the SHA attended the meeting: Mr Charles Goody, Chairman of the Authority, Bronwen Bishop Director of Primary Care Development and Corporate Services and Dr Mike Deakin Director of Public Health and Clinical Engagement

The following members of Cabinet attended this part of the meeting: Councillors P.J. Edwards (Cabinet Member - Environment), RJ Phillips (Leader of the Council), D.W. Rule M.B.E. and R.M. Wilson (Cabinet Member - Resources).

Councillors J.W. Hope M.B.E and W.J. Walling were also present

The following representatives of Health Bodies in the County were also present:

Hereford and Worcester NHS Ambulance Trust:  Mrs J Newton (Chairman), Mr R B Hamilton (Chief Executive).

Herefordshire Hospitals NHS Trust: Mr D Rose (Chief Executive)

Herefordshire Primary Care Trust: Dr P Ashurst, Non-Executive Director and Vice-Chairman of the PCT Board, Mr P Bates (Chief Executive), Mr S Hairsnape (Deputy Chief Executive).

Councillor W.J.S Thomas welcomed everyone to the meeting noting that representatives of Health bodies in the County were present and members of the Council’s Cabinet, including the Leader of the Council, reflecting the significance attached to the reconfiguration proposals and the united approach to health issues within the County.

Mr Goody explained that the focus of the consultation exercise, of which the presentation to the Committee formed part, was on health service structures not on services.

Bronwen Bishop then gave a presentation on the three consultations which were underway on the reconfiguration of Primary Care Trusts (PCTs), Strategic Health Authorities (SHAs) and Ambulance Trusts in the West Midlands.

She explained the background to the restructuring proposals, the detail of the proposals themselves and their expected benefits.

In terms of Primary Care Trusts and Strategic Health Authorities it was noted that the view was that to deliver a patient-led NHS required a strong commissioning function with strong PCTs, developing a wider range of services in response to the preferences, lifestyle and needs of local people.  The function and role of SHAs needed to be reviewed to support commissioners and contract management.

The benefits identified in terms of changes to PCTs were:

·          by reducing the number of NHS organisations money would be released for reinvestment in patient care.

·          sharing boundaries with social services providing local authorities would enable consistent joint working and the development of shared services.

·          larger PCTs would  ...  view the full minutes text for item 36.