Month: March 2018
Ever wondered why Highways fill potholes in poor weather conditions, and then the job has to be done again? It’s down to the ‘liability to repair’, a madness of the outsourcing system.
The most common complaint in parish councils the last few weeks has been that pothole repairs by Skanska, Devon’s Highways contractor, are too often failing, leading to the same hole being filled two or even three times in a short period. (While of course, holes which are not classed as ‘safety defects’ are left unfilled, as per the contract the Council has given them.)
When I asked about this, I was told that while Skanska’s work is mostly of a good standard, they are filling too many holes when roads are pouring with water or frozen. And the explanation for this – they have a contractual ‘liability to repair’ within certain deadlines (often ‘next day’). It seems to be another madness of the outsourcing system – if Devon didn’t need to specify the contractor’s liabilities so tightly, a more sensible approach to repairs could be adopted. Bring it all back in-house?
The high price of outsourcing: effects of Devon Highways contract changeover still being felt one year on
A full year after Skanska replaced South West Highways as the maintenance contractor for Devon Highways, the effects of the changeover are still being felt. Draining cleaning equipment ordered by the new contractor is still arriving, 12 months after they took over.
It is clear that all involved greatly underestimated the transition costs. A ‘demobilising’ effect in the last 6 months of the old contract was followed by low operational efficiency in the first couple of months of the new one, and Skanska have spent the last year learning how to do the job. (SWH, which originally took over Devon’s own direct labour department, had been doing it for 20 years).
The difficulties of transferring 250 staff to the new contractor and of managing the software transition were also underestimated. It all makes me wonder if provider changeovers – even when they’re planned and orderly and there isn’t a Carillion-style failure – aren’t a major downside of outsourcing Council services.
While we’re thinking about this, do remember that planning for Devon’s NHS Integrated Care System (formerly known as the Accountable Care System) has included provision for the effects of ‘provider failure’. Is this acceptable? Delays in filling potholes are one thing – delays in the NHS caused by costly handovers between providers could be quite another, even if planned.
I will be a member of a task group on Highways set up yesterday by Devon County Council’s Corporate Infrastructure and Regulatory Services Scrutiny Committee.
At Devon County Council’s Corporate Infrastructure and Regulatory Services Scrutiny Committee yesterday, campaigner Guy Cashmore told members that (up to September) Devon had the lowest uptake in the BDUK Phase 2 rollout – 5 per cent compared to a national average of 25 per cent. Cabinet member, Cllr Stuart Barker, who represents Devon on the board of Connecting Devon and Somerset (CDS), said that he was nevertheless confident that the target of 95 per cent of homes with super fast broadband by 2020 would be achieved.
The Committee approved a careful task group report on the rollout, with important recommendations for improved transparency, but my proposal that CDS board meetings should be open to the public (albeit with commercially sensitive discussions reserved) was defeated by 6-4.
£2.5m HoTSW money to improve mobile coverage in SW – but some operators say they don’t need the investment
At Devon County Council’s Corporate Infrastructure and Regulatory Services Scrutiny Committee yesterday, I asked how and when the £2.5m that the Heart of the South West Local Economic Partnership obtained to eliminate ‘not-spots’ in Devon and Somerset would be used.
Keri Denton, Head of Economy, told me that it had proved difficult to plan an effective intervention, as some mobile operators had told the Council they didn’t need the investment. She said, however, that others were interested, and they were continuing to look into how the money could be used to improve mobile coverage.
Over 60 people from community groups in the Seaton area spent yesterday morning in The Gateway (Seaton Town Hall) discussing the challenges to health in the town and surrounding villages. The meeting, chaired by Cllr Jack Rowland and addressed by (among others) Em Wilkinson-Bryce of the RD&E and Dr Simon Kerr of NEW Devon CCG, had wide-ranging discussions which launch a process to try to define the health services the area needs and the challenges we face. A full report will be drafted based on the eight sets of working group discussions and I will report further when this is available. A follow-up event to lead to more concrete conclusions is envisaged, probably in May.
‘Defer the Integrated Care System’ says Health Scrutiny Committee, after campaigners and councillors challenge CCGs’ failure to provide proper information on controversial scheme
Following my request for Health Scrutiny to consider the CCGs’ plans (at the last meeting in January), and challenges to the Conservatives’ attempts to push them through at DCC’s Cabinet 10 days ago, this Thursday’s Health Scrutiny called for a slow-down in the rush to implement a major reorganisation of the NHS which the public hasn’t been informed about – let alone consulted on.
County Councillor Claire Wright (Independent, Otter Valley) writes: The brake on the process was applied at yesterday’s (Thursday 22 March) Devon County Council’s Health and Adult Care Scrutiny Committee, which also recorded its concerns at the plans, set to be put in place next month.
The new system, which is coming into force in health areas across the country, will mean a merger of the two clinical commissioning groups in Devon, at least at board level to start with, and is widely being seen by campaigners across the country, as the beginning of a break-up of the NHS – and a clear route through to more privatisation and less public accountability.
Nationally, there are legal challenges by senior medics who are convinced that the move to ‘accountable care’ as it was originally called, will be disastrous for patient care and the public functioning of the NHS.
We are repeatedly told by local NHS and social care managers that it is just about integration of health and social care and is another step on a long journey. But that is disingenuous.
This is the start of a very new style of working and no one is very clear where it will end up. What is certain though, is that it is being driven by Conservative Secretary of State for Health and Social Care, Jeremy Hunt and if he tells the NHS to move in a certain direction, they must do as he says.
So although this new system debated at Devon County Council’s Health and Adult Care Scrutiny Committee yesterday is at an early stage, its direction of travel is clear. We are heading for a more formal set up of groups of organisations and no one can reassure members of the public how the governance or funding will operate.
For example, the NHS is free at the point of use and social care is means tested. So if budgets are merged, will social care become free at the point of use? Highly unlikely. So what does this mean for NHS care?
At yesterday’s Health and Adult Care Scrutiny Committee meeting, very well informed and articulate members of the public from the Devon Save Our Hospital campaign group addressed councillors, as well as Cllr Martin Shaw. Also, Cllr Julian Brazil (speaking on behalf of the LibDem group) who are very concerned about the plans.
Cllr Martin Shaw (Seaton Independent) was successful in getting the health scrutiny committee to take on this issue earlier this year and is incredibly well researched and informed on the issue.
Feelings and anxieties were running high during the meeting. Some speakers were heckled by members of the public, which prompted chair, Sara Randall Johnson threaten several times to throw them out.
Committee members had received dozens of emails from members of the public who wanted councillors to object to the plans.
Most of the committee fortunately, seemed concerned. I made the following proposal, which was agreed unanimously.
The section in brackets was very disappointingly, deleted by the Conservatives on the committee, despite the NHS representatives agreeing to a period of public engagement . This is a great shame, but I remain pleased that the rest of my recommendations were supported.
(a) record the Committee’s concerns over the emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, Mental Health Care Partnership and shared NHS corporate services;
(b) defer the Integrated Care System process until assurances are provided on governance, funding, the future of social care from a democratic perspective (and when a full engagement process has taken place – the part on public engagement was deleted by the Conservatives unfortunately);
(c) recommend Councillor Ackland’s paper and proposals on the reformation of the Health and Wellbeing Board as a sound democratic way forward to provide the necessary governance on a new integrated system;
(d) give assurance that the proposals will not lead to deeper cuts in any part of Devon as a result of the ‘equalisation of funding’;
(e) provide a copy of the business plan being developed and a summary of views from staff consultations.
Cabinet will now need to consider these recommendations.
If you wish to watch the debate, here’s a link to the itemised webcast – https://devoncc.public-i.tv/core/portal/webcast_interactive/318671
Pic: Standing room only. Yesterday’s Health and Adult Care Scrutiny Committee meeting.
Following news a couple of weeks ago that the Dermatology clinic in Seaton Hospital had been closed, whether permanently or not is not clear (it was GP-led and the GP stopped doing it, I am told), comes the information that Dermatology appointments are not currently available in Axminster, either. You have to go to Exeter, where they’re booking for June.
This is one of the most highly used specialities in both hospitals and it is a serious setback that it is not available locally!