I’m making a new proposal to safeguard community stakes in community hospitals, tomorrow at Health Scrutiny

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Here is my briefing note containing the proposal, to be considered at the meeting in County Hall at 2.15;
Ownership, Community Stakeholding and the Governance of Community Hospitals

Community hospitals in Devon have always been built and maintained with a high degree of community involvement and support. In many cases, local communities took the initiative to build the hospitals and raised substantial part of the original funding, or even the entire funding of additional wings and facilities, as well as contributing to staff and other running costs, the introduction of new specialist services, etc.

Unlike Private Finance Initiatives undertaken in partnership with private companies, these ‘community finance initiatives’ – which sought no profit from their investments other than the improvement of the facilities and services they enabled – appear not to have secured their interests in the hospitals they helped to build. The Leagues of Friends and others who raised funds for hospitals trusted that their investments would continue to be used for the benefit of place-based health services in their local area. 

Since the 2012 Health and Social Care Act, however, the organisation of the NHS has changed and the ownership of NHS buildings is in the process of being transferred to a new company, NHS Property Services, wholly owned by the Secretary of State and charged with managing the NHS estate in line with national priorities. NHS Property Services is enabled to sell off parts of the estate and to charge NHS organisations market rents for their use of NHS buildings.

This change creates dilemmas for local communities which have invested in Devon community hospitals. Clearly Leagues of Friends and other local bodies, including town and parish councils as representatives of communities which have raised large amounts of funding, can be considered ‘stakeholders’ in community hospitals. However these community stakeholders appear not to possess formal rights in the ownership and governance of the hospitals.

The proposal is that the Health and Adult Care Scrutiny undertake an investigation into

1. The changing ownership and governance of community hospitals in Devon and its implications.

2. The historic and ongoing contributions of local communities and Leagues of Friends to funding the hospitals. 

The purpose of this investigation would be to address the question of

3. How community stakeholders’ interests should be secured in the future governance of community hospitals.

It is envisaged that in the course of this investigation, the Committee would both collect evidence and invite expressions of views from all stakeholders, including both local community organisations and NHS bodies, including NHS Property Services.

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Aftermath of the Diviani vote

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I don’t want to comment at length on last week’s confidence vote at EDDC (which I missed while away for a week). I was pleased to hear that there were excellent public speeches, including from Seaton Mayor, Jack Rowland, and that two of Seaton’s councillors, Jim Knight and Peter Burrows, voted ‘no confidence’ in Paul Diviani, whose vote prevented Health Scrutiny from referring the beds decision to the Secretary of State.

I was disappointed to see that our third councillor, Marcus Hartnell, justified support for Diviani, seeing the attacks on him as purely politically motivated (apparently all other local councillors, for Coly Valley, Beer, Trinity and Axminster, also supported Diviani).

I would just like to put on record my belief that no council leader should be able to abandon the communities he represents without paying a high political price. I hope that the no-confidence motion will warn councillors aware that there will be an even greater public reaction, should they fail to block attempts to close any of our community hospitals in the forthcoming CCG Estates Strategy.

Budleigh victory saves hospital garden from Clinton Devon development

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A planning inspector has ruled against Clinton Devon Estates’ attempt to build houses on half of the Budleigh Salterton hospital garden (the hospital is one that has already lost its beds): https://eastdevonwatch.org/2017/09/07/clinton-devon-estates-and-budleigh-hospital-garden-a-pr-nightmare-for-today-and-tomorrow/

EDDC Leader faces ‘no confidence’ motion over his vote to condemn Seaton and Honiton hospital beds

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EDDC Leader, Cllr Paul Diviani, will face a vote of ‘no confidence’ next Wednesday, 13 September at a special meeting of the Council, over his vote to block the referral of the CCG’s hospital beds closures to the Secretary of State – which effectively condemned the beds in Seaton, Honiton, Okehampton and Whipton:

  • ‘On Tuesday 25th July 2017, Cllr Diviani chose not to represent the opinions of this Council or the people we represent at the DCC Health and Adult Care Scrutiny Committee meeting when he was clearly expected to do so. This Council no longer has confidence in Cllr Diviani’s commitment to represent our collective interests nor lead our East Devon communities as the figurehead for local government. We call for his resignation.’

    Proposed by Councillor Ben Ingham, seconded by Councillor Val Ranger and supported by Councillors Cathy Gardner, Matt Coppell, Marianne Rixson, Rob Longhurst, Dawn Manley, Geoff Jung, Peter Faithfull, Susie Bond, Roger Giles, Matt Booth, Peter Burrows, Steve Gazzard, Megan Armstrong and Douglas Hull.

Members of the public can speak for up to 3 minutes each at the beginning of the meeting.

A slightly abridged version of my reply to Cllr Diviani is published in today’s Midweek Herald (below).MW Herald letter Diviani Health Scrutiny

Health Scrutiny Chair should consider her position after rebuke and the County must act to restore confidence in scrutiny of NHS

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My press release:

6789739605_506f0ee322_oDevon County Council’s Health and Adult Care Scrutiny Chair, Councillor Sara Randall Johnson (right), should immediately consider her position following the stinging rebuke issued to her by the Council’s Standards Committee. The Council should also act to restore the credibility of Health Scrutiny, since its failure to fully scrutinise the removal community hospital beds in Honiton, Okehampton and Seaton has destroyed public confidence in its activities across a large swathe of Devon.

At its meeting on 29 August, minutes of which are published today, the Standards Committee agreed that while Cllr Randall Johnson had not broken the Members’ Code of Conduct, she should ‘be strongly reminded of the importance of the work of scrutiny committees – reinforcing the value of neutrality in scrutiny both generally and in calling the “health service” to account – and the need to be seen to be even handed and scrupulously fair, recognising that failure to do so may be perceived as a deliberate act.’

The call for a Scrutiny Chair to ‘be strongly reminded of the importance of the work’ of her committee, and of the value of neutrality and being seen to be even-handed and fair, is unprecedented and should lead Cllr Randall Johnson to immediately consider her position. There is no public confidence that she will lead the committee to carry out full and impartial scrutiny of NHS decision-making.

Effects on the Council’s reputation 

The Standards Committee also ‘accepts that the events of the Health and Adult Care Scrutiny Committee meeting on 25 July 2017 may not reflect well on individual Members or upon the Council as a whole, and further recognises that the perception gained by persons present at the meeting or subsequently viewing the webcast is not that which would have been desired’.

This stark acknowledgement of the damage done to Devon County Council’s reputation also requires early action by the Council to reassure the public that the Committee will do its job properly in future and protect the NHS in Devon.

The Scrutiny Committee ignored the views of local communities and their representatives and has allowed the CCG to get away with damaging cuts. The Council must now consider how to restore people’s faith that it will protect all our community hospitals in the future. I shall ensure that this is discussed when the Council meets on 5th October.

Sara Randall Johnson exonerated of breach of rules but reminded of ‘the need to be seen to be even handed and scrupulously fair, recognising that failure to do so may be perceived as a deliberate act’

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I’m posting extracts from the minutes of Devon County Council’s Standards Committee yesterday, concerning the allegations about Cllr Sara Randall Johnson’s Chairmanship of the Health Scrutiny Committee’s special meeting about the Seaton, Honiton and Okehampton hospital beds – mostly without comment,  because I haven’t yet had time to fully absorb them or to decide with colleagues how to respond. One brief comment at the end, though …

The resolution, unanimously agreed, states

(a) that the Investigating Officer’s Report be acknowledged and endorsed as an exhaustive and thorough piece of work;

(b) that the Committee finds that the allegations are not proven and that there has not been any breach of the Code of Conduct or that they disclose any sufficiently serious potential breach that might warrant punitive action or sanction or that the subject member failed to apply one or more of the Principles of Public Life;

(c) that there is no evidence to support any allegation that the subject member failed to adhere to the Code of Conduct or had failed to treat others with respect or had failed to act in the public interest or had acted improperly or did not have regard to the relevant facts before taking part in any decision making process as alleged, specifically, in relation to paragraphs 4 and 5(a), (c), (d), (g) and (h) of the Code and that that complaints cannot therefore be upheld;

(d) that, notwithstanding the above, the Committee accepts that the events of the Health and Adult Care Scrutiny Committee meeting on 25 July 2017 may not reflect well on individual Members or upon the Council as a whole, and further recognises that the perception gained by persons present at the meeting or subsequently viewing the webcast is not that which would have been desired: Group Leaders should therefore be asked to remind Members of the need to conduct themselves appropriately and respectfully at all times;

(e) that, additionally, the subject member be strongly reminded of the importance of the work of scrutiny committees – reinforcing the value of neutrality in scrutiny both generally and in calling the ‘health service’ to account – and the need to be seen to be even handed and scrupulously fair, recognising that failure to do so may be perceived as a deliberate act; the difference between perception and reality being not easily countered;

(f) that in light also of the evident lack of awareness of some Members of the procedures to be followed at meetings, further training be offered (i) to Members on the rules of debate including procedures relating to the moving of motions and amendments and voting at committee meetings and to remind them that assistance was available through the Council’s Democratic Services & Scrutiny Secretariat to help them in ensuring consideration of any matter by a Committee and in drafting motions or amendments and (ii) to Chairmen and Vice-Chairmen of  Scrutiny Committees, generally, relating to the management of those procedures at meetings;

(g) that Members be also reminded of the need to ensure microphones are switched on and used particularly when meetings are webcast and that Officers examine the potential within the current audio system to ensure that Members’ microphones are switched on remotely, if necessary, to ensure that their contributions are heard and recorded on the webcast;  [This would appear to relate to the fact that Paul Diviani’s comments cannot be heard on the webcast]

(h) that, additionally, the Procedures Committee be asked at its next meeting to ensure the wording of the Council’s Constitution in relation to the appointment and membership of Scrutiny Committees is accurate and consistent throughout and reflects the provisions of the law and that the presentation of information about such appointments at the Annual Meeting of the Council is similarly made clearer in future; and

(i) that complainants be advised that any complaint over the conduct of the Health and Adult Care Scrutiny Committee’s Co-opted Member cannot be dealt with by the County Council and that as that Member was currently an East Devon District Councillor any such complaints should be referred to East Devon District Council’s Monitoring Officer.

Additional comments from the Investigating Officer about the Committee’s ‘scrutiny’ of the CCG’s proposal:

‘In relation to concerns that the subject member did not guide or direct Committee Members sufficiently robustly to discuss the relevant issues set out in the papers before that Committee or upon which representations had been made direct to Members, the Investigating  Officer recognised that the subject member had been at pains to allow all parties present and able to speak with the Clinical Commissioning Group’s representatives, public speakers and local Members attending under Standing Orders addressing the Committee first and speaking on any aspect of the situation as they saw fit.  Thereafter Members of the Scrutiny Committee were invited to speak – without restriction as to subject or time – to enable them to raise any issues they may have wished so to do and enable an informed discussion/debate: only then coming to a view, having first heard all the arguments.

‘It was felt to be entirely reasonable to have assumed that Members of the Committee had read and digested the information before and that it was for Members themselves to refer or raise in debate and discussion any specific issues they felt were necessary or worthy of so doing.  The Investigating Officer was of the view that it would be wrong for anyone to assume that there had been no consideration of the issues highlighted in the Report CS/17/23 circulated at the 25 July meeting simply because Members had chosen not to speak specifically to any of those points.’

My comment – no one said ‘there had been no consideration of the issues highlighted in the Report CS/17/23 circulated at the 25 July meeting simply because Members had chosen not to speak specifically to any of those points.’ What we said, and I still say very strongly, is that there was not proper consideration, let alone scrutiny.

The full minutes, which will be posted on the DCC website shortly, are here: Standards Committee 29 August 2017