NHS
Why has EDDC refused to list Seaton and other community hospitals as ‘assets of community value’, when other Devon districts have done so? Jack Rowland will ask at the EDDC on Wednesday
Jack’s question:Seaton Area Health Matters reports on its activities to date
Jack Rowland, chair of Seaton Area Health Matters, has sent me this report:
So, what have we been doing recently?
From conversations earlier this year when we invited representatives from the statutory and voluntary health sectors the following 10 priorities emerged:
- To take an area approach for the Axe Valley, not just Seaton.
- Improving communication and co-ordination between voluntary organisations.
- Maintaining and extending NHS services in GP practices and at Seaton Hospital.
- The challenges in older age groups (chronic diseases, loneliness and isolation).
- The challenges in younger age groups (drug and alcohol addiction, housing, poverty).
- Mental health support.
- Transport difficulties to access services.
- Promoting health and wellbeing
- Communication on what is available.
- Co-ordination and ownership to tackle the challenges.
In order to look at these challenges a Steering Group was established and the membership is:
Jack Rowland (Chair) Seaton Town Councillor
Geoff Pook (Vice Chair) East Devon District Councillor
Marcus Hartnell East Devon District Councillor / Seaton Town Councillor
Victoria Parry Food & Wellbeing Charity / Clinical Commissioning Group Community Representative
Martin Shaw Devon County Councillor / Seaton Town Councillor
Roger Trapani Clinical Commissioning Group Community Representative
Tina Trapani Devon Senior Voice Representative
Dr Mark Welland Seaton G.P. & Chair of Seaton Hospital League of Friends
From this steering group 2 working parties have been looking at these priorities as many of the challenges are inter-connected.
One working party is producing a report to put forward a case for maintaining and extending NHS services as part of a health hub. A meeting has been arranged for 5 November at Seaton Hospital with senior representatives from the Royal Devon & Exeter Hospital.
The other working party has been collating information to establish the details of the voluntary organisations in our area that are involved in some way in health and well-being. The intention is to show the information, with the permission of the organisation, on this website and to also have a dedicated phone line available for people to use who may not have access to the internet. When the phone line is available we will publicise this on this website and by issuing a press release and using advertising posters around the town as well as social media.
We are also considering carrying out a Seaton Area survey to give everyone the opportunity to tell us their views on what they want to see in the area for health care and wellbeing provision – this would be in the form of both a paper format and online.
Okehampton Times picks up my campaign for the hospitals at the County Council
Okehampton, like Seaton and Honiton, lost its beds last year. Read their report.
Local Conservative councillors were scared to have their individual votes on community hospital closures recorded at yesterday’s County Council meeting
The big question about why the Tories were so determined to add ‘where appropriate‘ to my amendment that the County Council should work to save ALL Devon’s community hospitals is: Which hospital do they NOT think it is appropriate to keep as a community health and wellbeing centre?
I mentioned in my speech that East Devon councillors like Phil Twiss (Honiton) and Ian Hall (Axminster) had made it clear that their hospitals should be kept. And not one councillor popped up to make it clear that, yes, their hospital was the exception.
Tory leader John Hart told me that Teignmouth was a case, because the CCG was funding a new health centre there. But Teignmouth people are up in arms about the closure of their hospital and Teignmouth councillor Sylvia Russell was certainly not volunteering to support its closure.
Yet as far as I know all these councillors, and East Devon Conservatives like Stuart Hughes (Sidmouth), Richard Scott and Jeff Trail (Exmouth), Sara Randall Johnson and Ray Bloxham (Exmouth), voted to add the ‘where appropriate’ get-out (which presumably they think may be used for someone else’s hospital).
I say ‘as far as I know’ because the Tories also voted not to have their votes recorded on my amendment. As far as I know, all those mentioned also voted for this suppression of information, too! If I have inadvertently maligned anyone, in the absence of this information being recorded, please let me know.
The only Conservative who did not support the get-out was, as I said in my last post, Dartmouth councillor Jonathan Hawkins, who spoke movingly about the plight of his community since their hospital was closed.
Claire Wright and I win a commitment from the County Council to work to save ALL Devon’s community hospitals, although the Conservatives can’t stop themselves adding get-out clauses
In a hour-long debate in yesterday’s meeting, the Council adopted proposals which Cllr Claire Wright and I, the two Independent members from East Devon, put forward, in place of the original recommendation by the Cabinet.
The ruling Conservative group adopted (with a small addition) the wording of my amendment, which Claire seconded, which proposed to influence NHS decisions ‘in the direction of retaining all community hospitals to be used as health and wellbeing centres for their areas‘, in place of the original Cabinet recommendation to merely seek ‘decision making appropriate to individual circumstances, including population need and the quality of building.’
This is an important change in direction by the Council, which is now committed for the first time to work to retain ALL hospitals, as Claire (who proposed the original motion) had requested. The Conservative leader, Cllr John Hart, insisted on adding the words ‘where appropriate’ to my proposal, which we opposed because it provides the NHS with additional leeway to close hospitals. Cllr Hart’s addendum was too much for one Conservative Councillor, Jonathan Hawkins (Dartmouth), who voted with the opposition for my amendment without this addition, in the light of his community’s experience of the closure of Dartmouth Hospital.
The Devon Clinical Commissioning Groups could end this controversy with a clear policy statement that all remaining hospitals will stay open and will be supported as health and wellbeing centres for our communities. Until this happens, Claire and I, with the support of tens of thousands of people around Devon who are fighting for their local hospitals, will continue our campaign. On yesterday’s evidence, we are winning.
WATCH the debate online.
Health Secretary tells Conservative conference ‘the era of blindly, invariably closing community hospitals is over’ – we shall see if Devon Tories have got the message at this afternoon’s County Council meeting
In potentially game-changing comments for our hospitals in Seaton, Honiton, Axminster and Ottery St Mary, new Health Secretary, Matt Hancock said:
‘We’ve got to reform the system so we spend more time on prevention not cure, with more integration between health and social care, and more treatment closer to home.
‘What I mean by this is that the era of moving all activity into fewer, larger hospitals and blindly, invariably closing community hospitals is over. … I want more services closer to the communities they serve.’
Claire Wright has a motion on the hospitals at this afternoon’s County Council, which I am seconding and the Conservative Cabinet originally proposed to water down. We shall see if they have got the very welcome new message from their health secretary. It is certainly our job to make sure that they and the CCGs take note.
My plea for a new deal for health in Devon’s towns falls on deaf ears, as Devon’s Conservative Cabinet refuses to generally defend community hospitals
The indomitable Claire Wright made a new challenge to Devon County Council’s Cabinet yesterday to support keeping our Community Hospital buildings. I made a strong appeal which you can watch here for a new health deal for Devon’s towns, saying that if we really have ‘integration’ of health, wellbeing and adult care, DCC must take its share of responsibility.
As Claire writes (I had to leave before the discussion concluded) the Conservatives largely refused this – it amounts to the fact that we’re not integrated when it comes to the hard choices, which are being left to the CCGs.
Interestingly, the Chief Executive, Dr Phil Norrey, proposed the backstop position that funds from selling buildings should be retained and reinvested in Devon, rather than ‘hoovered up’ by the national NHS Property Company. Let’s be clear – they should be used for Devon’s towns, and especially in any towns which lose their hospitals, and not hoovered up either into funding the acute hospitals.
ENT returns to Seaton Hospital, but not Dermatology, as RD&E’s meeting with Seaton Area Health Matters to discuss local services is postponed for a month
Readers may recall that since April I have been querying the apparent withdrawal of ENT and Dermatology clinics from Seaton hospital. I have finally had an explanation. The ENT service at Seaton is provided is by Dr Rob Daniels, GP at Townsend House, who is directly commissioned by the CCG to provide GP with a Special Interest ENT and nurse-led ear suction. Apparently Dr Daniels was on 6 months’ sabbatical, but has now returned and had a full clinic booked for the 15th August.
Dermatology, on the other hand, was provided using a GP special interest service (GPwSI) provided by Dr Joe Pitt, who has left the area, and it is not currently being replaced. The RD&E says, ‘At the moment the majority of the dermatology activity for the east is taking place at Axminster where the dermatologists can provide minor ops. If the dermatologists feel a procedure needs a more complex intervention then patients are asked to have this undertaken at Heavitree.’ (Although in my knowledge, as I have told them, patients are sometimes referred directly to Heavitree.)
This is a shame since there was a substantial uptake for Dermatology in Seaton. We will have a chance to discuss its possible return when Seaton Area Health Matters, chaired by Jack Rowland, meets RD&E leaders to discuss the opportunities for local provision of services in general. This meeting, originally envisaged for this month, now looks like being in late October or early November.
Since the CCG will not announce decisions about the future of hospitals until after the conclusion of these discussions (which are also taking place in other towns), these will presumably be put back into 2019 – maybe even beyond the local elections in May?
The NHS in South Devon has signed a deal with a private company to build new health centres in Dartmouth and Teignmouth and handed over all NHS buildings in the area to it. Privatisation steaming ahead!
From BBC Devon website on 22 August (from a Facebook post, so I don’t have the link):
The NHS in South Devon has signed a deal with a private company to build new health centres in Dartmouth and Teignmouth and a new emergency department at Torbay Hospital. The firm, Health Innovation Partners, will also be in charge of all NHS buildings in the area.
Torbay and South Devon NHS Foundation Trust says it’s an “exciting partnership” which will give the NHS access to funds and expertise so it can modernise its old buildings and also build new ones. Critics though are concerned it is privatisation “by the back door”.
Campaign against Accountable Care Organisation contracts allowed to appeal against High Court decision, while NHS England begins consultation on contract which may not be lawful!
The Court of Appeal has issued an order granting campaign group 999 Call for the NHS permission to appeal the ruling against their Judicial Review of the proposed payment mechanism in NHS England’s Accountable Care Organisation contract. I am supporting 999 Call’s legal case. At the same time, NHS England has launched its public consultation on the contracts, which you can respond to here.
‘999 Call for the NHS’ says:
The Accountable Care Organisation Contract (now rebranded by NHS England as the Integrated Care Provider contract) proposes that healthcare providers are not paid per treatment, but by a ‘Whole Population Annual Payment’, which is a set amount for the provision of named services during a defined period. This, 999 Call for the NHS argues, unlawfully shifts the risk of there being an underestimate of patient numbers from the commissioner to the provider, and endangers service standards.
In April, the High Court ruled against the campaign group’s legal challenge to NHS England’s Accountable Care Organisation contract – but the group and their solicitors at Leigh Day and barristers at Landmark Chambers found the ruling so flawed that they immediately applied for permission to appeal.
Although fully aware of this, on Friday 3rd August – the day Parliament and the Courts went on holiday – NHS England started a public consultation on the Accountable Care Organisation contract – now renamed the Integrated Provider Organisation contract.
The consultation document asserts that the payment mechanism in the ACO/ICP contract is lawful, because:
“The High Court has now decided the two judicial reviews in NHS England’s favour.”
Steve Carne, speaking for 999 Call for the NHS, said
“It beggars belief that NHS England is consulting on a contract that may not even be lawful.
And a lot of public funds is being spent on developing the ACO model – including on the public consultation.
We are very pleased that 3 judges from the Court of Appeal will have time to consider the issues properly.
We shall shortly issue our stage 5 Crowd Justice appeal for £18k to cover the costs of the Appeal.
We are so grateful to all the campaigners and members of the public who have made it possible for us to challenge the lawfulness of NHS England’s attempt to shoehorn the NHS into an imitation of the USA’s Medicare/Medicaid system.
We will not see our NHS reduced to limited state-funded health care for people who can’t afford private health insurance.”
Jo Land, one of the original Darlo Mums when 999 Call for the NHS led the People’s March for the NHS from Jarrow to London, added,
“All along we have been warning about the shrinkage of the NHS into a service that betrays the core principle of #NHS4All – a health service that provides the full range of appropriate health care to everyone with a clinical need for it, free at the point of use.
Since we first started work two years ago on bringing this judicial review, there have been more and more examples of restrictions and denials of NHS care, and the consequent growth of a two tier system – private for those who can afford it, and an increasingly limited NHS for the rest of us.”
Jenny Shepherd said
“NHS England’s rebranded Accountable Care Organisation contract consultation is a specious attempt to meet the requirement to consult on a significant change to NHS and social care services.
We don’t support the marketisation of the NHS that created the purchaser/provider split and requires contracts for the purchase and provision of services.
Integration of NHS and social care services, in order to provide a more straightforward process for patients with multiple ailments, is not aided by a system that essentially continues NHS fragmentation.
This new proposed contract is a complex lead provider contract that creates confusion over the respective roles of commissioner and provider. It requires multiple subcontracts that are likely to need constant wasteful renegotiation and change over the duration of the lead provider contract. This is just another form of fragmentation, waste and dysfunctionality.
The way to integrate the NHS and social care is through legislation to abolish the purchaser/provider split and contracting; put social care on the same footing as the NHS as a fully publicly funded and provided service that is free at the point of use; and remove the market and non-NHS bodies from the NHS.
Such legislation already exists in the shape of the NHS Reinstatement Bill.”
The campaign team say they are determined in renewing the fight to stop and reverse Accountable Care. Whether rebranded as Integrated Care or not, they see evidence that it is the same attempt to shoehorn the NHS into a limited role in a two tier healthcare system that feeds the interests of profiteering private companies.
Steven Carne emphasised,
“It is vital that we defend the core NHS principle of providing the full range of appropriate treatments to everyone with a clinical need for them.”
999 Call for the NHS hope the 2 day appeal in London will happen before the end of the year. The Appeal will consider all seven grounds laid out in the campaign group’s application – with capped costs.
Details on the first instance judgment can be found here, and the judgment itself here.
David Lock QC and Leon Glenister represent 999 Call for the NHS, instructed by Rowan Smith and Anna Dews at Leigh Day.
Seaton & Colyton MATTERS 