NHS

New evidence that Brexit is harming NHS staffing – but Devon County Council has no figures for the local situation

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There is new evidence that Brexit is adding to the NHS’s chronic staff shortage. Far fewer nurses and doctors from other EU countries are coming for jobs in the UK, while many of those already here are leaving – or plan to leave.

Locally, the RD&E is struggling to recruit care workers for the ‘new model of care’ to replace community beds. Council officers freely admit that Brexit is making Devon’s social care recruitment crisis worse, and at the County Council meeting on 5th October I asked for figures on the number of people from other EU countries in health, social care and education in the county. The answer was that the Council can’t produce them – in a follow-up question I asked the Cabinet to remedy that, and also to reassure EU citizens that they are valued here.

Many people voted for Brexit partly to help the NHS – but are now realising that it is doing the opposite. Of course the Leave campaign said that it wanted to allow professionals like nurses and doctors still to come to Britain – it was more the unskilled workers it wanted to stop (although where that would leave our farming and tourism industries is another problem). What this argument overlooked is that doctors and nurses who move here are not just making a decision about a job – they are looking at whether the country is open and welcoming. The message that Britain didn’t want foreigners went out loud and clear to the people we need to keep our NHS going, as well as everyone else.

Leave voters rightly hoped to see more money go to our underfunded NHS. However it is now universally recognised that the Leave campaign’s idea of saving ‘£350 million a week’ was utterly misleading. Much of the money never goes to the EU (because of the rebate negotiated by Margaret Thatcher) and most of the rest comes back to support things like agriculture, scientific research and regional development in places like the South West – expenditure that the British government will need to replace. Recently it has become clear that the economy has fallen back since the referendum to the extent that the Government is already losing much more in tax revenues than it will eventually save by leaving the EU. So the NHS has no hope of gaining money from Brexit, and is hit on the staffing side too.

Green MP asks for crucial safeguards with new NHS Accountable Care Organisation contracts

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Photo of Caroline LucasCaroline Lucas Green, Brighton, Pavilion

‘To ask the Secretary of State for Health, whether safeguards are in place to ensure that the new model Accountable Care Organisation contract, published by NHS England in August 2017, will not result in fewer NHS services being provided than under the traditional NHS standard contract; and if he will make a statement.’

See her follow-up question and minister’s evasive answer.

NHS Chair: “We are more scared than we have ever been. We have the strong likelihood of hospitals being inundated with people suffering flu.”

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The chairman of NHS England, Prof Sir Malcolm Grant, speaking at the national children and adult services conference in Bournemouth yesterday, said: “We face winter better prepared than we have ever been, but more scared than we have ever been. We have the strong likelihood of hospitals being inundated with people suffering flu.”

Still the right moment to have closed our community hospital beds?

A poll of healthcare leaders found that 92 per cent are concerned about their ability to cope as the colder months arrive – but Devon Conservatives know better!

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They brushed aside concerns about beds in last week’s Council meeting. The Times also reports that it is too late for a cash injection to save the NHS from a winter crisis, according to a senior health official.

The new model of care is working, they say, but patients who could have been treated in Seaton Hospital are still bed-blocking in the RD&E

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Below is the RD&E’s latest publicity leaflet for the ‘new model of care’ boasting ‘no complaints’ from people who were treated between 28 August and 10 September. On the reverse side it features Doug – is it a coincidence that he is from Seaton? – who has had a knee amputation and is being cared for at home after two weeks on an acute ward. He says, ‘I cannot praise enough the wonderful care and treatment I have received right through from the surgical team to the community healthcare professionals. The skills and attention to detail they have shown is remarkable. It’s been a pleasure having them in my home.’

I am sure that the dedicated professionals working in the new system are doing their best for the patients. But are all the people who would have been transferred to the community hospitals actually getting the treatment at home which they are promised by ‘Your Future Care’? At the same time I received this comment from a Seaton resident: ‘A friend of mine’s husband has been in the RD&E for about 10 days.  He could have come home 4 days ago, but there was no home care arranged for him – no one available to do the job, so his wife is paying privately to get help, and he will now be coming home some time on Sunday. He will have been bed blocking for 1 WEEK.  It says it all doesn’t it?’

RDE YFC Stakeholder briefing 5 Oct 2017 FINAL

Devon Conservative machine backs Health Scrutiny travesty, blocks my last-ditch attempt to defend our hospital beds

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IMG_0315Yesterday the Conservative Party machine defeated my final attempt to get Devon County Council to take action over the closure of community hospitals beds. My motion, seconded by Claire Wright, asked the Health Scrutiny Committee to look again at the issues it failed to scrutinise properly in July, and asked the Council to write to the Secretary of State for Health to alert him to our concern about hospital beds. I highlighted widespread NHS concern that there will be too few beds if there is a flu epidemic this winter. My speech is printed below and you can watch it here.

The Tory response was an amendment, moved by the leader, John Hart, which took the guts out of the motion. Despite all the evidence to the contrary, it said that Health Scrutiny had ‘extensively considered the issues and concerns from members of the public, elected members and others, including medical professionals, all matters relating to the closure of some community hospital beds in Honiton, Okehampton, Seaton and Whipton.’

Instead of my proposal to write to the Secretary about the beds closures, the amendment proposed to write ‘seeking reassurance that appropriate funding is provided by government to deliver the necessary health and social care services in Devon’. Not a dicky bird to the minister about community hospital beds, the whole point of the debate.

In reply I told the Council (at 3.10) that if they passed this amendment, they would be ignoring East Devon opinion just like Kensington & Chelsea Council ignored the residents of Grenfell Tower; and the Conservative Group as a whole would have made itself responsible for the failure of scrutiny.

The result  Although they were not formally whipped, 40 Tories fell dutifully in line to support the amendment. There were 16 votes against (these were Liberal Democrat, Labour, Independent and Green members, together with only one Conservative, Ian Hall of Axminster).

Claire made a valiant attempt to put some guts back into the motion, with another amendment – but the Tory machine squashed that too.

During the Council meeting, the overhead display announced the date as ‘5 Octobe’, losing an ‘r’ in apparent tribute to the recent successful Tory conference, on which Steve Bell comments in today’s Guardian:

Steve Bell on Tory Conference

Text of my speech:

I represent a large division in East Devon. 2 years ago Seaton, Axminster and Honiton hospitals had in-patient beds, universally appreciated by patients & doctors, and supported by local communities. Today large parts of each hospital lie empty – nurses and other staff are dispersed – volunteers have been told they are no longer needed. We don’t even know whether the buildings will survive as centres of health services or be sold off.

This is the biggest crisis East Devon & Okehampton have faced in many years. Local communities have been united in their opposition; councillors of all parties have opposed the decisions.

After a biased consultation and unjust decisions, we looked to the Health Scrutiny Committee to hold NEW Devon CCG to account, and they have failed us. My proposal today is not a motion of NO confidence in any councillor or party. It is a motion to RESTORE confidence in this Council’s ability to represent Devon communities and stand up for their interests.

The tragedy is that Health Scrutiny started sensibly by asking the CCG 14 questions, in order to decide whether it should use its legal power to refer their decision. This proposal had cross-party backing, with the support of more Conservatives than members of any other party. A minority of the committee were, however, determined from the beginning to disregard public concern and voted not even to ask the questions.

The CCG replied to the questions but the Committee found their answers inadequate and wrote back detailing areas of concern. So far so good – a model of scrutiny. But things started to go wrong when the issue came to the new Health & Adult Care committee in June. The new Chair argued that members were insufficiently experienced to decide the issue and recommended delaying a decision until September 21st. It escaped no one’s notice that this was after the date given for permanent closure of the beds. It was seen as an attempt to prevent effective scrutiny.

Fortunately, the Committee agreed instead to a special meeting in July. For this meeting, the County Solicitor prepared a guidance paper outlining 6 issues outstanding with the CCG. Councillor Ian Hall, Councillor Mike Allen who is a Conservative District councillor, and others joined me in pressed the local communities’ case.

However the CCG gave a long powerpoint presentation which simply did not address most of the 6 issues, and before any debate could take place, Councillor Gilbert proposed there be no referral. In case anyone believed that he still wanted to scrutinise the issues, he made a point of emphasising that not referring would ‘save the committee a huge amount of work ’.

Councillor Diviani then told the committee that referral would be a waste of time, because ‘attempting to browbeat the Secretary of State to overturn his own policies is counter-intuitive’.

The Committee never discussed most of the remaining issues that the guidance paper had identified. Let me mention just one, the surprise decision to close Seaton’s beds, removing all provision from the Axe Valley. Neither the CCG nor any member gave any reason for believing this decision was justified – yet the committee voted for it anyway and the empty wards of Seaton hospital are the consequence.

There was no broad support for the anti-scrutiny motion: it was supported only by 7-6 ; 4 members abstained or were absent. The meeting was widely seen as an abdication of scrutiny. The Standards Committee says it ‘may not reflect well on the Council as a whole’. I would go further: it did not reflect well on this Council.

Since then, it has become obvious that cutting beds to the bone brings great risks. The Head of the NHS, Simon Stevens, has called for more beds to be urgently made available this winter in face of a possible flu epidemic. Expert bodies like the Kings Fund, the College of Emergency Medicine and NHS Providers have backed the judgement that the NHS is cutting too far, too fast. These are new reasons to question the CCG’s plans.

This motion therefore proposes that

  1. The Scrutiny Committee should look again at the issues which were not satisfactorily addressed.
  2. The Council should tell the Secretary of State that the CCG’s decisions and the wider STP process have aroused great feeling in Devon, that people are not happy with either the decisions or the way they were made , and we are worried that we simply won’t have enough beds for the coming winter.
  3. Finally, following a more constructive Health Scrutiny meeting on 21st September, this motion welcomes the Committee’s help in securing community hospital buildings.

Some of you may still wonder if Cllr Diviani was right, and all these proposals will be a waste of time. The answer to this is given in a recent letter from the Secretary’s own office: ‘As you may know,’ it says, ‘contested service changes can be referred to the Secretary of State, who then takes advice from the Independent Reconfiguration Panel.’ So a referral is not something the minister deals with personally; it is a legally defined procedure.

The letter continues, ‘However, as you are aware, Devon’s Health Scrutiny Committee … passed a motion … in favour of not referring the CCG’s decision to the Secretary of State.’ Cllr Diviani suggested that referral was pointless because of the minister’s opinions: the minister’s office implies it WOULD be meaningful, if only Devon would take action.

I ask you to restore this Council’s reputation and take the action which it is within your power to take, even at this late date, to save our community hospital beds.