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Paul Truswell. Presentation to National Leading Transformation of Health and Wellbeing Programme 14th January 2014. Have You REALLY Got to Know the Natives?. Have You REALLY Got to Know the Natives?.

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paul truswell
Paul Truswell

Presentation to

National Leading Transformation

of Health and Wellbeing


14th January 2014

have you really got to know the natives1
Have You REALLY Got to Know the Natives?
  • CULTURE SHOCK - NHS staff probably distant from Non Exec NHS board members. Have they had a rude awakening when they came into contact with Councillors?
  • They may be lucky. Those Councillors may be pliant and deferential. Or they may be experienced, knowledgeable and VERY demanding.
have you really got to know the natives2
Have You REALLY Got to Know the Natives?
  • Are staff fully awareness of the local democratic process and the pressures under which Councillors operate. How many of them have been on safari to witness what happens in the wild. Have they attended committees, panels, shadow a Councillor …
  • Have they made the transition from an NHS that is not democratically accountable at local level to a Council that is.
A Challenge

I am a Councillor grappling with the challenges of a ward with huge health inequalities. Massive government funding cuts mean I want every penny of Council budgets spent in a way that provides a tangible benefit to my constituents.

From what I’ve seen of Public Health people they:

  • are precious, patronising and overpaid
  • arrange lots of meetings, and write endless reports, strategies, profiles, questionnaires, surveys …
  • have a ring-fenced budget that we could make better use of
  • haven’t made the transition to the Council culture
  • still don’t understand the role and needs of Councillors

How do we win over the sceptics?

before they get to know you1
... Before They Get to Know You
  • DON’T regard yourselves as explorers bringing enlightenment.
  • DON’T assume they'll always be impressed by strings of beads ... or even JSNAs, JHWBSs, endless crunching of statistics, profiles, drafting of strategy documents, questionnaires, meetings … They want ACTION
  • DO get to know the Council inside out. Know its Directorates. Know the challenges. Know the resource and legal parameters.
no room for prima donnas1
No Room for Prima Donnas
  • Handing out prescriptions for someone else to do the work will not go down well.
  • Identifying inequalities is not an end in itself; nor is Identifying desirable outcomes . The real “beef” is HOW to meet those needs and achieve those outcomes in palpable, realistic ways; visible and valued on the ground.
  • Everyone hates a problem as much as they love a solution
  • Consultation? AVOID: What do we want? Paradise! When do we want it? Now!
you lucky people1
You Lucky People!
  • Ring-fenced PH budget - lucky in present climate, but envied. Make the most of it. One day, it may be absorbed into the overall grant/budget - then it’s open season and you’re fair game for those hunting for savings
  • It’s not enough simply to orbit in the Executive Board or HWB Board stratosphere
      • develop relationships with ALL Councillors
      • establish projects valued by Councillors and the Community
  • Executive Board system replaced Committees – placed decision-making in the hands of a few Councillors and Senior Officers
  • Many Councillors feel detached and distant from decision-making – opportunity at local level to engage them in their communities as HWB Champions
  • Be an assertive Champion yourself
honourable members1
Honourable Members
  • What, apart from the Portcullis on their notepaper, do they have in their arsenal?
  • Supporting your local MPs is an extension of your LA role. It’s not us and them, but a continuum - MPs love lobbying for national solutions to local problems
  • Early Day Motions–“graffiti”, but one way of raising an issue and gauging support – up to 2,000 a year
  • Parliamentary Questions (Oral/Written)– a battery of questions can be an effective bludgeon
honourable members2
Honourable Members
  • Adjournment Debates– 30-Minute Debate, secured by ballot; any Government issue; Minister responds. Briefings/speeches
  • Legislation– offer speeches; amendments
  • Private Member’s Bills –have one around if a local MP secures a high place in ballot.
  • Access to Ministers and Civil Servants
  • Select Committees– written/oral evidence; puts you/LA on the map