The review was carried out by Professor Catherine Staite, the former Director of Organisational Development at the Institute of Local Government Studies at the University of Birmingham, who has also has previously worked with the Audit Commission, the Legal Services Commission and the National Health Service in the UK.

Deputy Rhian Tooley is the Vice-President of the HSC Committee, which is completed by members Rob Prow, Dawn Tindall and Emilie Yerby. 

Professor Staite interviewed the five committee members and two senior civil servants about their thoughts on several principles that underpin good governance, including independence,  transparency, accountability, integrity, clarity of purpose and effectiveness. 

"The Committee understand the principles of good governance and seek to apply them to their work on the Committee. The Committee is also conscious of areas of weakness, e.g. external engagement and the need to assume themselves that their decisions have been fully implemented," said Professor Staite. 

"Leadership is crucial to good governance. It was evident from interview responses and observation that the leadership provided by the President is exemplary. Committee members reported that she listened to them and respected their individual views and contributions while maintaining momentum in the work of the Committee. She actively supports the Committee to build good governance into their work and leads by example."

HSC's primary responsibility is the PEH. But Professor Staite found it was difficult for the Committee to be responsible for delivery of their services in practice. 

Professor Staite also identified governance issues, particularly surrounding managing the boundaries between the roles of deputies and civil servants.

"The Committee mandate is confusing in terms of where the boundaries lie between Committee and civil service responsibilities. It places the responsibility on Committees to ‘oversee’ delivery and also be accountable for the services that fall within their remit. However, it is evident that the Committee cannot, in practice, be responsible for delivery of services," she continued.

"The Committee and civil servants manage what could be a contested boundary because they have strong working relationships. There is evidence of mutual trust and support across the Committee and between the Committee and the civil service. The Committee also understands the importance of a focus on strategic issues and resists the temptation to be drawn into operation issues, whenever possible."

Comments by committee members and senior civil, which are anonymised, highlighted several issues. They included:

• We don’t have the capacity to let other people know what we are doing and why – both internally and across the States.

• It's difficult to get engagement because of the Committee system, although other Committees do have roles in delivering the Partnership of Purpose. There’s no shared political oversight of all strategic objectives. 

• The States lack skills and capacity to engage effectively [with patients, users and carers].

• Engagement is poor [with partners]. A lot of time and resource is spent arguing with MSG about delivery.

• There are major gaps in Comms and the [States] website isn’t adequate. 

Pictured top: HSC President Heidi Soulsby.