Agenda and minutes

(a)  To approve as an accurate record and the Chair to sign the minutes of the meeting of the Health, Adult Social Care and Social Inclusion PAC held on 12^th Dcember 2016; and

(b)  To note the outstanding actions.

The minutes of the meeting held on Monday, 12^th December 2017 were agreed as a correct record.

Apologies for absence were received from Co-optee, Debbie Domb, Councillor Hannah Barlow and Councillor Sharon Holder.  Apologies for lateness were received from Councillor Joe Carlebach.

If a Councillor has a disclosable pecuniary interest in a particular item, whether or not it is entered in the Authority’s register of interests, or any other significant interest which they consider should be declared in the public interest, they should declare the existence and, unless it is a sensitive interest as defined in the Member Code of Conduct, the nature of the interest at the commencement of the consideration of that item or as soon as it becomes apparent.

At meetings where members of the public are allowed to be in attendance and speak, any Councillor with a disclosable pecuniary interest or other significant interest may also make representations, give evidence or answer questions about the matter. The Councillor must then withdraw immediately from the meeting before the matter is discussed and any vote taken.

Where Members of the public are not allowed to be in attendance and speak, then the Councillor with a disclosable pecuniary interest should withdraw from the meeting whilst the matter is under consideration. Councillors who have declared other significant interests should also withdraw from the meeting if they consider their continued participation in the matter would not be reasonable in the circumstances and may give rise to a perception of a conflict of interest.

Councillors are not obliged to withdraw from the meeting where a dispensation to that effect has been obtained from the Audit, Pensions and Standards Committee.

There were no declarations of interest.

This report sets out the budget proposals for Adult Social Care.  An update is also provided on any changes in fees and charges.  Cabinet will present their revenue budget and council tax proposals to Budget Council on 22^nd February 2017.  

Councillor Rory Vaughan, Chair, welcomed finance officers, led by Hitesh Jolapara, Strategic Finance Director, who was accompanied by Prakash Daryanani, Shared Service Interim Director of Finance for Adult Social Care & Public Health, Richard Simpson, Public Health Finance Manager.  Councillor Vaughan explained that a Corporate overview would provide context, as an introduction, followed by the Medium Term Financial Strategy (MTFS, Agenda Items 4 and 5) for Adult Social Care and Public Health, respectively.

Hitesh Jolapara provided a national context as a backdrop to the Hammersmith and Fulham budget setting process.  In what was noted to be the final autumn statement going forward, given in November 2016, there were some changes to the spring budget.  The budget had been closely scrutinised by the Office for Budget Responsibility (OBR) and the Institute for Fiscal Studies (IFS). The OBR headline key messages forecast a weaker national economic outlook, weaker sterling, lower investment, with uncertainty created by Brexit, making it difficult for public finances to balance budgets nationally before the end of the current parliamentary session. 

It was explained that the GDP (Gross Domestic Product) for March and November 2017 varied between 2.2 and 1.4, percentage change on 2016.  Councillor Andrew Brown commented that, while he accepted current figures, previous OBR forecasted figures and economic modelling had been discredited.  The Bank of England and the Organisation for Economic Co-operation and Development (OECD) more recent analyses had indicated a rise.  Hitesh Jalopara, explained the difficulties inherent in forecasting, and responded that Councillor Brown’s perception of the differences was accurate.  Since the autumn statement, the US elections had taken place, which, combined with other global factors, led some commentators to forecast a rise in GDP.

The difficulty of forecasting was notable in the change in growth of national debt, predicted for 2017/18, at March as £1677 billion, later increased in November by £163 million to £1840 billion.  Locally forecasted debt for Hammersmith & Fulham was £37.1 million. Using fuel duty as an example, this neatly illustrated the difficulty of predicting figures, covering the period 2008/09 to 2020/2021, as all policy assumptions had been proven wrong by the actual fuel duty rate recorded at the time.

Hitesh Jolapara presented data taken from the IFS, on real term % changes to public spending, 2010-11 to 2019-2020, drawing comparisons between the total public spend, the revenue spending of London boroughs and local government core funding for London.  The steep decline in figures for the latter illustrated the severity in real term cuts to core funding in local government. It was confirmed that this did not take into account the devolution of business rates to local authorities and that this was not planned until the end of the current Parliamentary session (2019/20).  It was noted that if and when this occurred, it may be accompanied by the transfer of other responsibilities such as transport. 

A baseline budget of £160 million took into account a number of factors ranging from the council tax freeze to rates of inflation.  The budget was not limited  ...  view the full minutes text for item 115.

This report sets out the budget proposals for Public Health. An update is also provided on any changes in fees and charges.   Cabinet will present their revenue budget and council tax proposals to Budget Council on 22nd February 2017.

Richard Simpson, Public Health Finance Manager, provided the third portion of the budget presentation which addressed the budget for Public Health.  He indicated that in addition to the requirement to meet mandatory public health duties and to improve the public health of the wider local population, there were also several service area priorities including smoking cessation, improved sexual health and improving preventative health care and mental well-being.  The impact of the MTFS for 17/18 was that Public Health would begin to fund outcomes being delivered by other areas across the Council and amounted to £4 million. 

Councillor Brown sought clarification on this point, noting that that Public Health funding was ring-fenced.  Richard Simpson explained that the grant reduced by 2.5%, in cash terms representing £0.5 million, the £4 million from MTFS, represented an increase from current investment of £2 million.  This was a movement of £2 million from public health isolated services, to fund public health outcomes identified across the Council and did not represent a cut to overall public health services.

It was noted that the Department of Health (DH) grant was ring-fenced and had been transferred to local authorities in 2013, with the condition that the ring-fence would remain in place for 2017/18.  Referencing an earlier point about business rates funding services, the autumn statement from 2015/16, indicated that this would be the long term aim for Public Health funding too.  Councillor Brown enquired about potential uplift, with the devolution of funding reflecting increased investment in public health.  Richard Simpson responded that devolved funding did not necessarily mean extra investment.  Hitesh Jolapara clarified that as yet, the devolution of business rates funding was unknown and while we could try to attract additional services, this could become complicated, for example, the resolution of business rate appeals, using Westfield as an example to illustrate.

The Public Health Strategy had identified £0.907 million in savings to commissioned services and a further review would be conducted in 2017/18.  It was explained that this would allow money to be moved across the Council to fund public health outcomes being delivered by other departments.  Referring to GUM (Genito Urinary Medicine) to illustrate, one method by which savings would be achieved was through contract re-procurement.  Councillor Lukey confirmed that this involved LBHF, WCC and RBKC in a joint arrangement.  All three were keen to take this forward, and were dealing with different generations who were open to self-assessment using digital platforms, making it much more manageable. 

In response to a query from Councillor Brown about the proportion of public health spending on cardio vascular disease, smoking and lung disease or diabetes, Mike Robinson, Director for Public Health, explained that while they had not undertaken this type of analysis, they would first examine the expenditure made through the public health prioritisation framework and regard it as an investment generating future returns. He explained that they were undertaking some programme budgeting work which will look at what proportion of the NHS budget is spent  ...  view the full minutes text for item 116.

The H&F Poverty and Worklessness Commission recently completed its review of poverty and worklessness in Hammersmith and Fulham.  The final report contains a programme of ten recommendations and is presented to the PAC for scrutiny and public debate.

Councillor Vaughan welcomed Tom Conniffe, Principal Policy Strategy Officer and Programme Manager, supporting the work of the Poverty and Worklessness Commission.  He was accompanied by Christina Smyth, Chair of the Commission.  The resident-led Commission had been established in November 2015, and comprised of a total of 15 local representatives drawn from a wide variety of backgrounds which included voluntary, third sector public organisations as well as local individuals.  The Commission had met eight times, with their final meeting taking place on 18^th January 2017, and followed a broad work plan that aimed to formulate recommendations for interventions and/or services redesign, to deliver better outcomes for local people living in, or on the edge of, poverty and/or worklessness.

Formal constitution of the Commission was followed by a design phase, analysing data sources.  Bespoke work was commissioned regarding work and social interventions in the Borough, and undertaken by the New Policy Institute, who were also part of the Commission’s lifespan.  The qualitative research included working directly with residents of the Borough and the draft report was signed off at the final meeting of the Commission in January, following consultation with officers and Commission members.  This was the first public debate on the draft report, and will eventually be considered at Cabinet on 27^th March. 

Christina Smyth, Chair of the Commission, explained that the executive summary of the report provided an overview, with the detail of the work contained in the body of the report, which still required finessing.  Referring to the Root Causes section (page 15 of the report), the correlation between worklessness and poverty in six root causes included high levels of poor mental health and well-being, and, few affordable housing choices.  This included those individuals accommodated in poor quality housing or employed in low paid work, challenging common assumptions about the profile of individuals experiencing poverty or worklessness.  These were increasingly, groups of people who had been left behind and who found it difficult to engage. 

Christina Smyth observed that in the past few decades, little had changed in the Borough.  Historically, the Borough had always had areas of extreme wealth, alongside areas of deprivation, with the relative positions remaining unchanged.  Despite the level of income in the area, the value had decreased.  The Commission was intended to empower residents, with a strong lead from the Council acting as an enabler, to develop something which was sustainable and cohesive.

Co-optee Patrick McVeigh welcomed the report and observed that services should have to go to people, rather than the other way around, given the challenges of social housing.  He supported the development of community hubs and greater resident involvement, with volunteering opportunities, training advice and the chance to develop skills and experience. 

Co-optee Bryan Naylor also welcomed the concept of local hubs and the report itself, but noted that that the report did not recognise the poverty experienced by older, isolated people.  Referencing the work of Citizens Advice Bureau (CAB) and AGE UK volunteer advisors,  ...  view the full minutes text for item 117.

The Committee is asked to consider its work programme for the remainder of the municipal year.

Members considered the items provisionally arranged for March and April meetings and agreed the Work Programme attached as Appendix 1 to the report.

RESOLVED

That the report be noted.

Wednesday, 8^th March 2017

Wednesday, 26^th April 2017

The Committee noted the dates of meetings for the reminder of the municipal year:

Wednesday, 8^th March 2017

Wednesday, 6^th April 2017