‘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.
Off to Exeter – no Dermatology appointments in either Seaton or Axminster now
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!
Save Our Hospital Services demonstrating outside CCG and Health Scrutiny at County Hall on Thursday 22nd
How the private sector is helped to burrow deep into the NHS – today’s email from the Health Service Journal
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The ‘Integrated’ euphemism for dubious health care institutions – homeopathy got there first
I learnt this week that the Royal London Homeopathic Hospital has been renamed the Royal London Hospital for Integrated Medicine, now that the NHS has finally withdrawn funding for homeopathy’s wholly unproven treatments.
Meanwhile on 1st April, Devon’s CCGs will launch what was supposed to be an Accountable Care System (ACS) for the NHS and social care. Now it too has been rebranded as an ‘Integrated Care System’ – because ‘accountable care’ smacks of an American-style Accountable Care Organisation which could have opened all of Devon’s NHS to being run by a single private provider.
If it walks like a duck … quack! quack! seems particularly appropriate.
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.
Foster carers and Exmouth breastfeeding group protest cuts at Devon County Council
About twenty Devon County Council foster carers came to support four of their number who addressed the council (left) over changes to their contracts which they say will stop them from being able to continue in their work. (At the budget meeting, Independents had proposed extra funding for foster care rather than increasing reserves.)
Just before this, a representative of Busom Buddies Breastfeeding Support Group in Exmouth presented a petition with 600 signatures to Leader John Hart (right), calling on the Council to restore funding for their full-time worker who is essential for the valuable work the group does in helping mothers who have difficulty with breastfeeding.
Conservative complacency on rural broadband roll-out on display at Devon County Council
Devon County Council managed not to spend £2 million it was supposed to contribute to Connecting Devon and Somerset’s roll-out of broadband and mobile phone coverage in rural areas, because CDS didn’t need the money. When I pointed out that many people were having to wait far too long, and asked if the money couldn’t be used to speed things up, Conservative Cabinet Member Cllr Stuart Barker said that that was up to CDS, not Devon County Council to decide.
