My Lords, the Government have made no assessment. We believe that local areas are best placed to make funding decisions to ensure that local needs and circumstances are best taken into account. In total, we have provided £43.5 million to local authorities for funding Healthwatch this year. We believe that transparency on funding is important. We will be requiring each local Healthwatch to publish the funding it receives from local government in its annual report.
My Lords, I am grateful to the noble Earl for that response. I am, however, amazed that he says that he has no direct information on this matter. Is he aware that at least 23 local Healthwatch organisations have budgets lower than those of their predecessor organisation and that one of them—the one covering the Mid Staffordshire area—has a budget 19% lower than its predecessor LINk organisation? Are the Government nonchalant about how this money is being spent and about how patients are to be represented at a local level because they want to ensure that there is no vociferous view from patients about the scandalous way in which local health services are deteriorating as a result of both the top-down reorganisation that this Government have imposed and the real-terms cuts in budgets that have taken place?
No, my Lords. As the report from Robert Francis identified, the patient voice has to be at the heart of the health and care system, and Healthwatch plays a crucial role in supporting that as the new consumer champion for health and social care. It is very easy to get fixated on the amount of money that is going into Healthwatch. One additional consideration could be the investment that a local authority may be making in other areas to ensure that the voice of service users and the public is heard—for example, through the voluntary and community sector. Surely what matters are the outcomes that are achieved for service users and the quality of those services.
My Lords, are good activity and good results really coming out of these Healthwatch groups? In particular, have they done anything to help stroke victims or underprivileged or autistic children? Can the Minister give us an update on what good they are doing and whether they should be continued?
I am grateful to my noble friend. The first annual report from Healthwatch England was laid before Parliament on 9 October and it outlined some encouraging progress at both a national and a local level. There are already examples of the impact that local Healthwatch is having—for example, the work of Healthwatch in Peterborough, which is looking at how to improve health outcomes for offenders. My noble friend mentioned autism. I am aware that Healthwatch Cornwall uncovered a gap in the services meant to deliver a diagnosis of autism in children. That work resulted in a really practical solution so that families could access a diagnostic service without losses to other services in the area.
My Lords, will the noble Earl acknowledge that, certainly from the point of view of people who are working on the ground, the process we are going through is somewhat different from that set out by my noble friend, with whom I hate to disagree? There are obviously challenges at the moment, particularly in A&E, as the noble Earl is aware, but many of the changes have brought a lot of good news for health trusts, and my own in particular. However, the Healthwatch bodies—certainly locally where my trust is involved with them—need some support and guidance about what they are meant to achieve. It may seem odd but there is still some ambiguity about who is doing what. We are working with them as an acute trust to make sure that we can link with them, but there needs to be more clarity about their role.
I am grateful to the noble Baroness. She is certainly right that some local Healthwatches have got off to more of a flying start than others. I am aware of many that are working closely with their local clinical commissioning groups and indeed with provider trusts. However, others need encouragement and support, and we have created Healthwatch England to provide exactly that kind of support. That is the route for the Healthwatches which find themselves in some uncertainty about their role.
I am very much in sympathy with that thought. However, it is up to the local Healthwatch organisation to organise its funding as it sees fit and in the most cost-effective way possible. I would not want to dictate to them what they should do but, clearly, for a Healthwatch to work effectively, one has to have volunteers who are ready and willing to do the work, which might involve the need to reimburse them for some expenses.
My Lords, we will be responding to the recommendations from the Clwyd/Hart review in the context of our response to the Francis inquiry, so there is a limit to what I can say today. In answer to the noble Lord, I think that the local Healthwatch has an important role to play as patient champion and it is right that individual local Healthwatch organisations have access to information about complaints so that they can spot the themes and trends that emerge from them.