At the Council for Disabled Children (CDC) we are worried about how the joined-up assessment process for disabled children is going to work in the context of GP commissioning. We know that GPs lack specialist knowledge and expertise, and that the relatively small number of disabled children within "average" consortia will be too small for effective commissioning, while the NHS commissioning board is too far removed from the process.
Transparency is also a major issue. If "no decision about me without me" is true, who will make the decisions on and for children and families, and how will we know who is responsible? Where will the voices of children and young people be represented? How will the system be held accountable and by whom? For children's services, particularly for those with complex health needs, we see little accountability and transparency in the current bill or the dialogue around it.
So what do we want to see?
We want to see children's issues specifically part of health and wellbeing boards, with a local cross-commissioning remit. We need to see lead or cluster commissioning for children that combines both financial viability and expertise. Multi-agency working with and between skilled professionals and collective responsibility between agencies is essential.
Children's voices as a key part of HealthWatch would also be a good place to start, otherwise the pause in the Health and Social Care Bill may be a full stop in the development of better health outcomes for disabled children and their families.
Christine Lenehan, director of the Council for Disabled Children at the NCB
