Demand for democratic control in new Integrated Care System for NHS and social care dominates Devon County Council cabinet discussion
A passionate demand by Labour Councillor, Hilary Ackland (below), for greater democratic control in the new Integrated Care System for health and social care made a major impact as Devon County Council’s Cabinet finally considered the proposals which the Clinical Commissioning Groups have been developing since September.
Cllr Ackland said that a revamped Health and Wellbeing Board should be an Integrated Commissioning Board with decision-making powers in the new system, and proposed broader, cross-party representation.
I agreed that ‘democratic control is not an optional extra’, and said that governance proposals should be discussed before the Council approved the system. Replying, the opportunity for greater democratic input into the local NHS was emphasised by Chief Executive, Phil Norrey. Conservative Cabinet member, Cllr Andrew Leadbetter, had proposed a paper which agreed that governance issues needed to be addressed but made no specific proposals. The issue will now go to Health Scrutiny, hopefully on 22nd March.
In my speech, I welcomed the CCGs’ retreat from the idea of an Accountable Care Organisation, for which I said the judicial review joined by Stephen Hawking, as well as the hung parliament and local campaigners’ pressure, should take the credit.
- I also drew attention to uncertainty about how the financial organisation of the new system will impact on chronic failures of patient care.
- I warned that attempts to equalise funding between areas of the county could lead to even sharper cuts in Eastern Devon.
- I pointed out that the CCGs, even after 6 months, had failed to produce a single paper describing the Local Care Partnerships which are a key element of the system.
- The paper called for ‘public engagement’ – but there has been none, and even councillors do not understand the proposals.
I called for a delay in decisions until fuller information on all these points, as well as governance, was available. But the Cabinet unanimously adopted the proposals as they stood – the issues will go to Scrutiny before coming to full Council.
The debate is at 1.44, resumed at 2.22, in the webcast.