Paul Crossley

Yesterday I sat on my first O&S panel. Our Council introduced the new modernised system in May 2002 and for the next 5 years I was the Leader of the Executive and Council and so was scrutinised. Since May, when the Conservatives formed a minority Cabinet with Labour and Independent support, I have been on our development control panel but yesterday subbed for a colleague on holiday and sat on my first scrutiny.

We were scrutinising two decisions of the local PCT - the first to move some Gyneacological Cancer treatment from our RUH to a centre of excellence to be based in the UBHT in Bristol and the second to reduce the out of hours cover at Paulton hospital. It was fascinating and for both reviews we heard passionate and informed arguement and reason for and against both moves. Each was half a day hearing and there were a lot of people in for both sessions. We had representatives from the B&NES PCT, RUH, UBHT, patients, surgeons, forum members, Action for Pensioners, representatives from Wiltshire and others.

Our task was to determine whether there had been a 'substantial variation' in the service that warranted us instructing the PCT to halt the change and to go back and consult with the community.

On the Cancer changes we unanimously decided that there was a substantial variation with a negative impact on service to residents and users. We instructed the PCT and the hospitals to put a halt to their change plans and conduct a proper public consultation. We asked that we were to be involved in the consultation and that the consultation should also consider whether the best base for the Centre of Excellance should be the UBHT or the RUH. Apart from the powerful arguements from patients and RUH medical staff we were not convinced that the PCT and its partners had really investigated the concept of value-add for the change or indeed shown any evidence that outcomes would improve. It had a distinct feel of government tick-boxing.

On the Out of Hours sevice change we also decided unanimously. This time that there was not a substantial impact and that in fact adequate cover was provided by a variety of means. However we did ask that in future the panel should be consulted before changes that impact on residents are made. We have also asked that we receive a six monthly report on statistics of the way and means that people seek help from the NHS between midnioght and 8am in our area. Again we had passionate logic for and against. The facts that moved me to my vote were the presentation from a leading member of the local Action for Pensioners who said the money could be better spent on other services and ensuring people knew how to contact health care out of hours and the RUH presentation which said there had been no increase in numbers arriving at the A&E unit due to reduced cover at the Paulton Hospital.

The panel is Chaired by our Labour Leader - Adrian Inker - and additionally has three Conservative and three Liberal Democrat Councillors. The Conservative Cabinet member sat and listened to most of the day but made no contribution.

First impressions of scrutiny from the front-line Councillor perspective. I really enjoyed it and felt that the panel had investigated two important subjects and come to two important decisions. I think the PCT was expecting the first and hoping for the second. All in all it was much more enjoyable, instructive and worthwhile forum than the committees I used to sit on under the previous model of governance.

With the new intake in May this year moans about the new system and how good the good old days were finally seem to be drying up. There is though still a real issue at the level of concentration of power in the new system and particularly where there is a directly elected Mayor.