2. Citizen Engagement (CE)
What is absent from NHS II is a statement setting out the real added value of effective CE, which will be essential for successful reorganisation. Although statements are rightly made about the importance of CE, this is treated in a fairly mechanical way in the NHS II consultation and unrelated to other relevant developments, for example, the CHC Review and the Audit, Inspection and Regulation in Wales consultations. It is not considered worthy of consideration in the Public Health document, although this issue has been previously raised with the Public Health Framework Strategy manager.
CE does not start on an equal basis with other very well resourced professional interest groups. Without this understanding of the need for adequate resourcing and support, too much reliance can be placed upon voluntary effort, which is much less effective than it should be. This aspect will become increasingly important as we move into a new era of financial restraint and a growing emphasis on community based services, which are outside the traditional remit of CHCs. In the context of managing increasing costs of health service delivery, it is also noted that the Wanless emphasis on the significance of 'full public engagement' is an essential ingredient in managing public expenditure in a future 'age of austerity'.
Although hardly mentioned in the 'Audit, Inspection and Regulation in Wales' consultation, professional health regulatory bodies, such as the NMC, GDC, HPC and the GMC are all striving to find new ways of engaging with service users. For example, the Professional Health Regulators PPI Forum recently organised a UK consultation on how the needs of a growing diverse older population could be met by health professional regulators. How we reap the full benefits of professional regulation to achieve improved quality public service delivery can be found in detailed proposals made in relation to the proposed Professional Forums - see later.
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