One of the papers that came before Cabinet today was the approval of the structure, terms of reference and make up of the Shadow Health and Well Being Board in Cambridgeshire, which is being created as part of the changes being made to Health delivery in England through Andrew Lansley’s changes to the NHS. This is a formal committee of the county council.

The cabinet member for Health and Wellbeing, Martin Curtis, and I have been working closely together to ensure we have maximum buy in from all organisations for this important new board.

At the recent leaders and chief officers meeting I had agreement on the structure from the NHS, GP’s, Police, Fire and all the districts with the exception of the Lib Dem controlled city council.

Today, at cabinet, again the Lib Dems wanted a bloated board that would inhibit decision making. We know that Lib Dems don’t like decisions and when they do eventually make them they often change their minds at the vital moments ( see previous blog entries ). That is not the way to run something as serious and important as the health and wellbeing of our citizens.

We considered carefully the make up of the board. Firstly we wanted it to be small enough to be an efficient vehicle for delivery, secondly that we wanted everyone to be able to have their voice heard, but recognising that not everyone could have a seat on the board without it becoming too cumbersome. Thirdly, we recognise this is a shadow board for 18 months so if we need to alter anything we can. Easier to add someone than to try and take them off later.

As a result, we created a board of eleven members, including me, the Leader of The County Council, the cabinet member for Health and Wellbeing, a representative from the District Councils, a number of statutory Council Officers and representatives of the Health Sector. Importantly, we also agreed to create a number of networks underneath this, including Local Health Partnerships to ensure some of the thinking is done in a more localist way. We also agreed for the District Councils would be able to create their own network so that their representative on the board could speak for all.

Where does democracy fit into this structure? Firstly, our overview and scrutiny function will be looking at the board and examining it – that committee includes District Councillors and Liberal Democrats. The Local Health Partnerships will have councillors on them (including in some places Liberal Democrats) and the Board itself has three Councillors. So, whilst maintaining an efficient top level structure, we have managed to make the overall structure localist and democratic.

Of course the Lib Dems oppose this and always seek the largest organisation possible to avoid any personal leadership or responsibility. They have opposition firmly in their DNA and I intend to firmly keep them in opposition.