Davy Jones Consultancy

Another Care Quality Commission report – another ghastly story about elderly patients being neglected. Local Government managers might well be thinking: “there but for the grace of God, go I”.

Reading the Care Quality Commission report on how one fifth of hospitals might be breaking the law on their poor care for the elderly, it is a salutary reminder of the value of what have become dirty words in recent years – regulation and inspection.
These unannounced inspections found dreadfully poor care in a disturbing number of hospitals. And this from a sector that still has inspections and a national inspectorate, that has not yet suffered massive budget cuts, and that has at least a nominal national and local patient voice.

How worried should we be then about local government?
It is true that there are still inspections for the most vulnerable local government clients – children and vulnerable adults. But the Audit Commission is to be abolished. Regular inspections of all other services will be a thing of the past, to be replaced by “self assessment” and “peer reviews”.

More and more councils are cutting back on senior management posts to save money. Indeed some are cutting out the role of Chief Executive altogether, leaving it unclear where the buck stops. And every council in the land is facing major cutbacks to its services – with non-statutory but vital frontline services under threat.

Many councils still have inadequate mechanisms for involving citizens in service and budget choices. There is no local citizen voice - the ballot box is a somewhat blunt instrument for dealing with day-to-day service issues. The duty to involve citizens is being scrapped (while bizarrely it is being simultaneously strengthened in the NHS).

Accident waiting to happen?
Isn’t it just a matter of time before this toxic combination of service cuts, reductions in managers and clear lines of accountability, a lack of any serious citizen voice and involvement all lead to more terrible local government scandals and tragedies? And the cry will go up for inspection and regulation!

Surely one of the lessons from the CQC report is that the patient voice was not strong enough and not listened to. It is even weaker in local government and due to be weakened further. It really is time that the LGA took a long hard look at its self-regulation model and realised that it is inadequate. Councils assessing themselves is never going to be good enough or acceptable to local people. Empowered citizens must be at the heart of any assessment of local services – otherwise we will end up back with rolling inspection programmes again!