Weekly political news round up – 11th November

November 11, 2016 in News by Whitehouse


This week, the Welsh Assembly published the draft Public Health (Wales) Bill which is now going to the Committee stage to hear evidence on its provisions; and attention has been given to the increasing trend for local authorities to integrate health visitors and school nurses into wider public health services to make efficiency savings. A Parliamentary Written Question also asked what the Government’s opinion was on the Children’s Commissioner’s recent report on the impact of bureaucracy on school nurses.

Outside of politics, six Swansea doctors said they are seeing “shocking” under-development in Welsh children, with many children entering school without toilet training or the ability to brush their teeth. The Health Foundation, Nuffield Trust and the King’s Fund issued a joint statement on the Autumn Statement; and finally, the Public Accounts Select Committee confirmed they will be holding inquiries into NHS financial sustainability and integrating health and social care in early 2017.

Parliamentary and political developments

Public Health (Wales) Bill draft published

The Public Health (Wales) Bill is now being debated by the Welsh Assembly, after a draft of the Bill was introduced on Tuesday. It focuses on promoting children and young people’s health through its measures on smoking; intimate piercing; pharmaceutical services; and provision of toilets.

A local toilets strategy is presented in the Bill, which will make it statutory for local authorities to prepare and publish a local toilets strategy that must include:

  • An assessment of the need for toilets for public use in the local authority’s area;
  • A statement on the steps the local authority proposes to take to meet that need; and
  • Any other information the local authority considers appropriate.

“Toilets” include changing facilities for babies and disabled persons. Councils must review the toilet strategies after each local election and publish their revised strategies. Any person who is likely to be interested in the provision of local toilets in a local council’s area must be consulted by the local authority before it publishes its local toilets strategy. As part of this consultation process, the local authority must make a draft local toilets strategy available to interested parties.

Rebecca Evans, Welsh Minister for Social Services and Public Health, in her statement on the Bill to the Assembly, said that besides minor technical changes the Bill contains the original provisions considered by the previous Assembly and will cover a “number of important public health issues”. On public toilet provision, Evans assured other AMs that the Welsh Government will be issuing guidance to local authorities to help develop their local toilet strategies. Caroline Jones, a UKIP AM, asked the Minister why the Bill does not place a duty on councils to provide public toilets, to which the Minister replied that the strategy must also include how the local authority will meet the needs of its local area.

The Bill will now go to the Health, Social Care and Sport Committee for consideration of its general principles. They will be meeting five times over the next two months to hear evidence from professionals and Rebecca Evans. It will then be debated in Plenary sessions where the general principles will be refined.

Local authorities intend to reform public health nursing services

The moves by local authorities to change public health visiting and school nursing services, due to funding cuts to their budgets, has received coverage in the Nursing Times this week. Manchester City Council is one local authority planning to integrate 0-19 health services with other early intervention work to make efficiency savings; the council estimates that it could save £500,000 in 2018-2019 if a new health visitor contract is created.

The move is part of a new, wider early years delivery model, which will see teams of health visitors, early years’ workers and school staff operating out of twelve “hubs” based in or next to schools. Manchester City Council opened a consultation on the plans on 3rd November, and has urged local people to have their say before it ends on 15th December. Other councils such as Solihull, Slough and Essex also plan to redesign and integrate children’s public health services into other services.

Parliamentary Written Question asked about school nurses

In a Parliamentary Written Question tabled this week, Lord Taylor of Warwick, a non-affiliated peer, has pressed the Government on bureaucracy facing school nurses. Lord Taylor asked: “what assessment they have made of comments by the Children’s Commissioner for England on the impact of bureaucracy on the ability of school nurses to promote children’s well-being”.

Lord Nash, Parliamentary Under-Secretary of State for Schools in the Department for Education, replied that Public Health England published a model specification for commissioning services to inform decisions around the commissioning of school nurses. The minister also said that professional pathways and guidance to support local delivery of school nursing services provided by PHE is currently under review by stakeholders, including National Health Service England, and is expected to be published in Spring 2017.

According to the minister, technology could be used to address the burden of paperwork, as many services are now using technology and digital platforms to improve productivity and access, particularly for young people who are more technology-literate than others.

Clinical developments

Welsh children showing significant under-development

Doctors from six GP practises in Swansea have voiced concerns about the “shocking” under-development being exhibited by Welsh children. The GPs said that increasingly, children starting primary school have not been toilet trained; have limited speech; and do not know how to brush their teeth. Last year, 35% of children aged four in Swansea did not meet the expected level of development when they started in schools, with some schools finding only a quarter of children reaching average development indicators.

The six doctors have subsequently recruited a specialist worker to help families stop underdeveloped parenting skills repeating across generations. Dr Ruth Dare said many parents lack basic parenting skills because they have not experienced “stable, consistent” parenting in their own childhoods. The work builds on the focus of the Swansea Healthy City Partnership, which is concentrating its efforts on the first 1,000 days of children’s lives.

Nuffield Trust, the Health Foundation and the King’s Fund’s issue joint statement on the Autumn Statement

The Nuffield Trust, the Health Foundation and the King’s Fund have produced a joint statement on what they believe the 2016 Autumn Statement should prioritise in the health sector. It includes updates to the joint impact assessment of the 2015 Spending Review on the NHS and social care the three organisations carried out. The statement contends that the upcoming Autumn Statement must address the “critical state” of social care, as the publicly funded system is facing a £1.9 billion funding gap for 2016-2017 which is significantly impacting on the performance of the NHS. The assessment also disputes the Government’s belief that the NHS will receive £10 billion between 2015/16 and 2020/21, as analysis show that the Department of Health’s budget will increase by only £4 billion in real terms and will fall to 6.9% of GDP by 2020-2021.

The joint statement reiterates the arguments recently put forward by the Health Select Committee, the Public Accounts Committee and Simon Stevens, Chief Executive of NHS England, that the Autumn Statement must address the social care crisis and that the “£10 billion” figure is inaccurate.