The privatisation of democratic scrutiny: the strange case of Lancashire Healthwatch
The Lancashire Evening Telegraph reports (i.e. copies and pastes a press release) :
A NEW organisation to improve health and social services in Lancashire has been unveiled.
Lancashire County Council has joined forces with Parkwood Healthcare to form a new health watchdog called HealthWatch Lancashire.
Parkwood specialises in providing staff, including nurses, care assistants and project workers, to the NHS, private and voluntary organisations.
From April 2013, the new organisation will replace the current Lancashire Local Involvement Network (LINk) as an independent watchdog, listening to local people’s concerns and ensuring the best services for them.
In dryer terms, Parkwood Healthcare has won the contract from the County Council to run Lancashire Healthwatch (see No.5 in May 2012 Cabinet minutes), pursuant to the Health and Social Care Act 2012.
Clause 183, para 2.2 of that Act requires the following in respect of such a contract:
The arrangements must be made with a body corporate which—
(a) is a social enterprise, and
(b) satisfies such criteria as may be prescribed by regulations made by the Secretary of State
This makes the award of the contract look very odd. I have checked out Parkwood Healthcare on the Companies House site and it is a Private Company Limited by Shares. As such, it is surely outwith the normal definition of a social enterprise.
So have the County Council acted illegally in awarding the Healthwatch contract to Parkwood Healthcare?
Well, maybe, or maybe not. The Health and Social Care Act, courtesy of a late amendment in the Lords (unchallenged by any member of any party), provides a definition of what itmeans by ‘social enterprise’ (Clause 183 para 7):
For the purposes of this section, a body is a social enterprise if—
(a) a person might reasonably consider that it acts for the benefit of the community in England, and
(b) it satisfies such criteria as may be prescribed by regulations made by the Secretary of State.
Now, I’m a pretty good at ‘reasoning’, even if I say so myself, but I don’t consider that Parkwood Healthcare ‘acts for the benefit of the community in England’, precisely because the organisation’s legal status is not one normally associated with social enterpise.
Further, we don’t know what criteria may be prescribed in the secondary regulations, because those regulations are still a matter for consultation; indeed those consultations appear to have a particular focus on what ‘social enterprise’ is to be taken to mean (see Issue 1 in these slides).
So in summary, we have a (Conservative) County Council apparently offering a ‘social enterprise-only’ contract to what is clearly a private firm, but which might just arguably be considered a social enterprise under Andrew Lansley’s new regulations. Except that they haven’t been issued yet.
Further, the contract has been awarded to a Lancashire-registered firm which, at least judging by the website section on the nursing agency part of its business, may have a financial interest in delivering some of the services that it is now being contracted to scrutinise*.
At the very least, I think Lancashire County Council needs to be asked a few questions about this**, including whether it has made provision in the contract with Parkwood Healthcare for its termination/withdrawal, in the event that the secondary legislation makes such a contract unlawful.
* We should be clear that this is not entirely new. According to its accounts, Parkwood Healthcare already has contracts to “act as the host for voluntary organisations to meet and influence service provision” in Lewisham, Harrow and Greenwich, while also offering nursing agency services in the London area.
These contracts come under the previous government’s Local Involvement Networks (LINk) legislation, but the difference is that in these cases their ‘hosting’ services have been subject to a degree of accountability from those members that make up the Local Involvement Network itself (cf. the Lancashire LINk board structure, for example). Under the new Healthwatch provisions there appear to be no such safeguards, with LINks simply abolished in favour of Local Healthwatch arrangements.
** I should stress, not least so as to avoid any risk of legal action, that I am in no way suggesting that Parkwood Healthcare has acted improperly in tendering for the Lancashire Healthwatch contract. It is the Council’s actions that I question.