Agenda item

To receive a report from the Strategic Director for Adult Social Care and Health.  The original intention for considering this report was to allow the Commission to submit comments for subsequent consideration by the Overview Select Committee (OSC) at its meeting on 13^th February.   The report was not available for the Commission’s last meeting on 14 January 2014.

The OSC consider comments received from scrutiny commissions that had met prior it meeting and have reported their views to the City Mayor, prior to the City Mayor making his final proposals to the Council meeting on 26^th February, 2014 when the final budget will be approved.

Members are asked to note the report.  A copy of a presentation on a briefing for Members on the Public Health Budget is also attached for information at Page No 95.

The Strategic Director for Adult Social Care and Health submitted a report on General Fund Budget 2014/15 to 2015/16. It was noted that the original intention for considering this report was to allow the Scrutiny Commissions to submit comments for subsequent consideration by the Overview Select Committee (OSC) at its meeting on 13^th February.   However, the report was not available for the Commission’s last meeting on 14 January 2014.

The OSC considered comments received from scrutiny commissions that had met prior it meeting and have reported their views to the City Mayor, prior to the City Mayor making his final proposals to the Council meeting on 26^th February, 2014 when the final budget would be approved. 

A copy of a presentation on a briefing for Members on the Public Health Budget was also submitted for information.

Councillor Palmer made the following comments and observations on the budget proposals:-

·         There had been a fundamental difference in approach to the budget setting process this year and that the savings targets identified in previous years had been rolled forward to be delivered.

·         There would be 18 major service spending reviews and the City Mayor acknowledged that there needed to be an agreed approach to how scrutiny commissions and the Overview Select Committees would be involved in these reviews over the next two years.

·         The current year had been the first year of inheriting public health responsibilities from the NHS and the emphasis had been to take stock of the new services during the transition period and to ensure that there was no interruption in service provision.

·         The priority was now changing it was important to examine how the ring fenced public health budgets were spent and where the priorities for service provision should be focused.  33 commissioning reviews of public health procurement had been initiated as part of this changing priority.  These reviews would also be linked to the Corporate Procurement Plan.

·         The service reviews would look at each service afresh and would not simply be a mechanism for rolling on the service provision.  For example, some priorities currently contracted out may be better placed within the Council to combine elements of control and delivery through Trading Standards, Licensing and Public Health services.

Following comments made by Members, Councillor Palmer stated:-

• It was intended that all the public health service reviews would be considered by the Commission but discussions would take place with the Chair to decide at which point of the overall process would give the most added value. 

• The Council’s priorities could change over the next 2 years as the understanding of need changed together with the greater understanding of the services arising from the review.  It was hoped that there would be a reasonable amount of flexibility and innovation for providing services within the ‘ring-fenced’ public health budgets

• Flexibility would need to be built into the commissioning process to provide for possible break points and reshaping service delivery should expectations and spending priorities change.

• It would be helpful if all scrutiny commissions included health inequalities impact considerations in resolutions when they considered reports on proposed service changes.  There was a challenge for everyone to consider how any changes may impact upon physical or mental health and to draw attention to them.

• He was yet to be convinced that including a health implication comment on all reports would achieve or secure the change in culture required, as sometimes the other categories of comments on reports were seen as a ‘tick-box exercise’.

In closing the Chair welcomed Councillor Palmer’s comments relating to inward commissioning as he believed that with the re-integration of the public health functions within the Council some services could be provided in more holistic manner.  He also felt it was disappointing that there had not been an Equality Impact Assessment of the budget proposal this year, as this had been useful in previous years to assess the positive, negative or neutral effects of proposals on health.  However, he felt that it would not be unreasonable to ask the Public Health Teams to provide assessments on the impact on health and inequalities of the service reviews.

RESOLVED:

i)             that the report and the Deputy City Mayor’s comments be noted.

ii)            that the Public Health Teams be asked to provide assessments on the impact of on health and inequalities of service reviews.