Patrick Vernon in profile

The London Borough of Hackney is home to people with some of the poorest health in England. But the chair of the council’s Health in Hackney Scrutiny Commission, Councillor Patrick Vernon, is optimistic that the council can influence health services and improve local settings for health. He spoke with Andrew Ross.

The London Borough of Hackney’s health statistics tell a worrying tale: according to Dr Jose Figueroa, Consultant in Public Health at the City and Hackney Teaching Primary Care Trust (PCT), the borough has relatively high infant mortality rates, low life expectancy for men and high rates of teenage pregnancy, mental ill-health and tuberculosis.

It seems like evidence of another troubled inner city borough. And yet the council’s recent 'I Love Hackney' campaign doesn’t feel like a hopelessly optimistic exercise in trying to making lemonade out of lemons. The Audit Commission says that the borough is the most improved council in London, crime is down 22% and the authority area has more parks and green spaces than any other inner borough in the capital.

Bringing scrutiny to the people

Nonetheless, the Health of Hackney Scrutiny Commission (Hackney’s scrutiny panel) has plenty of ill health to investigate.

Councillor Patrick Vernon (Labour) is the Chair of the commission. His credentials for the role are impeccable (see CV highlights below) so it is no surprise that, on becoming a Labour councillor in 2006, Patrick’s colleagues swiftly installed him to head up the commission. And he was quick to begin to mould its operating style based on his past experiences.

Patrick Vernon in profile

Age: 45

CV highlights:
Chair, Health Scrutiny for the London Borough of Hackney (2006–present)
Specialist Health Adviser, Neighbourhood Renewal Unit (2005–present)
Adviser, Health Inequality Unit, Department of Health (secondment, 2003–04)
Director, Brent Health Action Zone (1999–2003)
Regional Director, South East England Mind (The National Association for Mental Health) (1995–99)

Stays healthy by: drinking in moderation, having a balanced diet (always a challenge, says Patrick) and taking long walks and bicycle rides down Hackney Marshes.

Scrutiny

He says:

“The average person doesn’t know much about scrutiny. They see the council as one big structure and that’s it. But I want to use scrutiny processes to have greater dialogue and to engage with the public.”

To that end he oversaw the recruitment of two non-statutory co-optees from the community onto the commission. The positions were advertised and nominees attended briefing sessions before two were selected.

One of the appointees, Jon Pushkin, runs a local voluntary sector organisation called The Sharp End which provides active ageing services for older people. He says he applied to be on the commission because

“if there is to be scrutiny, then it is important for the voluntary sector to be involved as well as the local authority.”

Patrick stresses that these appointees shouldn’t be seen as speaking for the community: “They don’t represent the community but they are an important interface between the commission and the public.”

Health conference

He has also recently initiated and hosted the commission’s inaugural Health Conference 2007. This was a free event where senior figures from the relevant PCT and health trusts presented an update on the performance of their organisations. Members of the public were given an opportunity to ask questions, and there were a number of spirited and informed exchanges.

Patrick says that:

 “I’ve tried to push the boundaries of health scrutiny and to make it publicly accountable. When I chair meetings I do it in such a way that everyone contributes. It has its challenges because some people try and take liberties at times. But it is one of the very few scrutiny commissions where you actually have the public attending.”

Meetings

Councillor Maureen Middleton, a Conservative member of the commission, confirms that the public do come to commission meetings. She says:

“The meetings are totally open and non-partisan. The commission is working quite well and we are developing interesting inroads into scrutiny.”

Patrick hasn’t only worked on improving community understanding of the role of health scrutiny. Middle ton says:

“it has also been important for him to build relationships with our core partners like the [City and Hackney] PCT, and to communicate with member colleagues about the role of scrutiny”

Getting the public switched on to health scrutiny – tips from the Health in Hackney Scrutiny Commission

• co-opt non-statutory members of the public onto your scrutiny panel/commission
• publicise the changes in council or PCT policy resulting from scrutiny recommendations
• ensure that meetings are genuine opportunities for members of the public to have their say
• develop a framework for investigation that includes race equality and diversity, and patient and community involvement, especially from black and minority ethnic communities
• hold events which are organised by the scrutiny panel/commission
• make presentations at community meetings and conferences
• explain health jargon in ways that people will understand
• respond to local health concerns

Holding the NHS to account

According to the Centre for Public Scrutiny [www.cfps.org.uk], the 2001 Health and Social Care Act formally enabled authorities with responsibility for social services to ‘review and scrutinise health service matters, and to make reports and recommendations to NHS bodies’.

The current state of NHS finances is never far from the headlines, and in recent months this has had a knock-on effect for the work of the commission, which has led to a revamping of its work programme.

Patrick says that:

 “There is an expectation from the public that councillors will know what is happening regarding NHS cuts and finance. So commission members need to be informed. I don’t want them to make decisions based on passion or anger – I try to make sure that we have papers presented, have a debate and then we can come to a view.”

More to health than the NHS

Some critics of health spending have long argued that too much focus on the NHS means that not enough money is invested in health prevention.

Patrick agrees:

“The NHS can’t tackle health on its own. The local government community has a key role through its main spend – housing, planning, social care.”

Inequalities are a significant health issue in Hackney. Patrick argues that this makes it even more important to get the views of black and minority ethnic (BME) communities:

“We need to try and encourage more BME representation in terms of evidence – we need representation from everyone so we can make an informed decision.”

Can health scrutiny make a difference?

Patrick’s view that the public generally are unaware of what health scrutiny is poses the question of whether it can have an influence. He is optimistic about the answer:

“It is important to raise the profile of scrutiny to ensure that we are recognised for the work we do. For example, one of our recommendations that has been implemented by the council was to remove vending machines from local schools. Often the impression can be given that it was their idea in the first place – but actually it was done by health scrutiny.”

For Patrick, the future for health scrutiny in Hackney is for the commission to continue to find solutions to the health challenges facing the borough.

“What I want to avoid is the commission having to do another scrutiny report in ten years time on obesity and coronary heart disease. I hope by then we will be able to focus on something different.”

This article was written by Andrew Ross for the IDeA and was published in March 2007.