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.
Outsourcing is a problem, not a solution, say Opposition councillors at Devon County Council
Councillor Yvonne Atkinson (Exeter, Labour) proposed this motion at Devon’s Cabinet yesterday:
This Council is concerned that outsourcing Devon County Council (DCC) contracts can reduce financial flexibility and the ability to respond to changes in policies and facilitate effective cross department working across interrelated DCC services in complex areas like the health and wellbeing of children. Accordingly, DCC can no longer afford to be locked into long term, difficult if not impossible to vary contractual schemes for services like Children and Mental Health if it wishes to remain responsive to the needs of Children from birth to age 25.
In view of cross party concern to fully and effectively integrate cross department working in children’s health and mental health services and education Devon County Council should bring back key services in-house and manage them in the wider public interest including value for money (defined broadly to include effects on public revenues and community wellbeing at large) and social value tests.
The Conservative Cabinet did not accept this but you can watch to the debate starting with Yvonne’s speech and concluding with mine, which focused on the failure of outsourcing in Highways – especially the botched handover between contractors last year.
I put the Dorset and East Devon National Park idea on Devon County Council’s agenda – the Cabinet will invite the national review to visit the County
Yesterday Devon’s Cabinet discussed my proposal, in response to the Government’s review of National Parks, that the County Council support a National Park for Dorset and East Devon.
The official briefing paper stated: ‘A National Park brings together in one organisation responsibilities for conserving and enhancing the environment and heritage; promoting enjoyment, recreation and wellbeing; and fostering the economic and social wellbeing of its communities.’ In my speech (which you can watch here) I talked about the threats to the existing Areas of Outstanding Natural Beauty from development – for example at Woodbury – as well as these advantages.
The Cabinet’s response (see minutes, 12c) was positive in so far as it welcomed the review and invited the review panel to visit Devon. I hope this will give those of us in favour the opportunity to present the case.
At the same time, the Cabinet ‘deferred any expression of support for the establishment of a Dorset and East Devon National Park unless or until the overriding benefit of this approach to Devon’s wider interests is clearly demonstrated.’ This caution was quite expected but it does not close the door, and that is encouraging.
Part of the problem over this issue is that East Devon’s ruling Conservatives refuse to engage with the proposal. This is driving Dorset campaigners to focus simply on their county (see logo), which is crazy since East Devon’s areas of outstanding natural beauty adjoin theirs, and we share the Jurassic Coast World Heritage Site for which a National Park would be an obvious complement.
I’ve asked Colyton Grammar School and LED to find a way to continue much-valued daytime dance and fitness classes
I have been approached by many users of Leisure East Devon dance and fitness classes held at Colyton Leisure Centre, who are angry about proposals under discussion by Colyton Grammar School (of which the centre is part) to end LED’s use of it on two mornings each week, which enables these classes to take place.EDDC response to new Government planning targets could threaten Green Wedge between Seaton and Colyford
A new EDDC strategy document, Principles For Accommodating The Future Growth Needs Of East Devon, does not propose the Seaton area as an area of large-scale growth, but still raises the spectre of developing the Green Wedge between Seaton and Colyford and bringing the reserve site near the Wetlands (removed from the Local Plan) back into play for housing:
8.11 Seaton – The town is constrained by topography particularly to the east and west but there is some limited scope for growth to the north of the town. The capacity to the north of the town would depend on the extent to which developing in the existing green wedge separating the town from Colyford would be accepted. The local plan had included a reserve site which still has potential while the allocated site for employment and community purposes has not come forward and may need looking at again. Clearly there are sensitivities to the north of the town in terms of the landscape given that it is rising land but also with the green wedge designation between Seaton and Colyford.
Background The Government is setting targets for each district which in East Devon will mean around 844 extra homes per year. The document also says that to ‘also achieve Members aspiration to deliver one job per home we will also need to deliver enough employment space to accommodate at least 844 jobs per year.’
EDDC welcomes this growth as a way of offsetting the effects of austerity; ‘The continued growth of the district and the future incentives form a vital element in the mitigation of the future financial pressures anticipated from 2020/21 as detailed in the financial plan.’ It even claims that ‘Continued growth is required to finance the councils Habitat Mitigation Strategy as well as other local infrastructure investment.’ (Growth is required to mitigate the effects of growth!)
Problems Neither this paper nor the Greater Exeter Strategic Plan consultation document included in the same papers (which EDDC was unhappy with and is now being revisited) faces up to the fact that – except close to Exeter where they believe new estates should be concentrated – demand for housing is mainly from incoming retirees. This is why the projected need for employment land could be exaggerated.
In recent years, East Devon has had the highest rate of net domestic migration, well over 1 per cent p.a., of any district in England. Demand also includes a sizeable proportion of second homes: this may help explain why the report says, ‘East Devon is one of the few places in the south west where housing delivery has exceeded population growth by more than 0.5%’.
Certainly little of the housing is for local young people, not surprising as ‘the ratio between average earnings and average house prices is in the region of 11.42’.
Areas of Outstanding Natural Beauty The report says: ‘As custodians of these areas it is considered inappropriate to put significant growth in these areas although some authorities are doing this due to a lack of alternatives. That is not to say that there should be a moratorium on growth in the AONB’s. Any growth in AONB’sunder our own policies and government policies must conserve or enhance the landscape character of the area and major development should only be accommodated where it cannot be accommodated elsewhere.’ However we know from the recent Woodbury decision that this still means significant intrusion.
Poor infrastructure One of the reasons our area isn’t proposed for growth is probably that, as the report recognises, ‘Smaller towns and villages are losing services and facilities due to austerity measures and economic change and residents are becoming increasingly dependent on travelling to larger service centres and are often doing this by car due to poor access to public transport, convenience etc.’
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?
Poll shows South West voters swinging away from Brexit as ‘no deal’ disaster looms
Voters in the South West are demanding a People’s Vote by a clear margin, a YouGov poll on behalf of the People’s Vote campaign, revealed on August 9th. It is the first significant test of public opinion in the region since the Brexit referendum in 2016.
Some key findings from the poll of over 1,000 people living in the South West include:
- Voters wanting a say on any final Brexit deal negotiated by the government by a clear margin of 42% to 35%.
- If talks break down and the choice is between staying in the EU or no deal, that margin widens to 47% to 27%.
- Having voted to Leave in 2016, the South West now backs staying in the EU by 51% to 49%.
- 76% of Labour voters in the region now want to stay in the EU, versus just 24% who still want to leave.
- Young people in the South West overwhelmingly want to stay in the EU, by a margin of 86% to 14%.
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.
Claire Wright sets up support group for people who are struggling with the Department of Work and Pensions, such as those on working tax credits or who are trying to claim PIP or carers allowance
Claire Wright, my Independent colleague on the County Council, says:
“Hi, I have set up a support group for people who are struggling with the Department of Work and Pensions, such as those on working tax credits or who are trying to claim PIP or carers allowance, for example.
The first meeting is on Tuesday 21 August at 7pm, in the Institute, Yonder Street, Ottery. The meeting is primarily for people living in my council ward, however, I won’t turn anyone away.
Please help get the message out there by liking and sharing this post. Many thanks:
Claire Wright
Devon County Councillor
Otter Valley Ward”
Any demand for this kind of group in Seaton and Colyton?
Seaton & Colyton MATTERS 