East Devon Alliance invites local politicians to Exeter health crisis rally

“To: Hugo Swire MP, Neil Parish MP, Mel Stride MP, Sarah Wollaston MP, Anne‑marie Morris MP, Peter Heaton‑jones MP, Gary Streeter MP, Geoffrey Cox MP, Kevin Foster MP, Oliver Colvile MP, Johnny Mercer MP

Cc: Jon Ashworth MP, Jeremy Hunt MP, Ben Bradshaw MP

Dear all,

As a representative of residents in East Devon I am addressing this to Devon MP’s but also to those in senior positions in parliament.

Will you be there when the National Health Service Bill (Margaret Greenwood MP) has its second reading? (By the way, that will be on 24th February 2017)

Will you back this bill? If not, why not?

Be aware: your electorate are watching. We in the East Devon Alliance are doing all we can to let them know how you vote on NHS and other healthcare issues, to counter the messages you try to get out down here that you are ‘against’ the current proposals to close community hospital beds. We know this issue is far bigger than that. We know that the 2012 Health and Social Care Act paved the way for the dismantling of the NHS. It’s taking a while for the public to wake up to what is being done, but they will.

And where is Labour? I am afraid a media blackout might be stopping us from hearing from the ‘opposition’. If you can mobilise your supporters all over the country, we will hit the headlines. Come the next election you might find there are new candidates opposing you in your previously safe seats. Or the person who gave you a run last time is out in front.

Are you prepared to continue with this programme to dismantle the NHS? Or do you have the courage to speak out and vote to reverse the changes?

Will you join us in Exeter on 3rd December to parade your support for the NHS as it was?

Please do let me know your position.

Yours sincerely,

Cllr Dr Cathy Gardner
Leader
East Devon Alliance

http://www.eastdevonalliance.org.uk/cathy-gardner/20161124/open-letter-mps-ministers-nhs-reinstatement-bill/

Devolution: “flawed fiscal ‘power’, an unjust system, unfulfilled potential”

“… local authority funding (for services) will become far more volatile as year to year income will be intrinsically linked to those who pay rates locally and those who choose to appeal. So, in sum business rates devolution in its current guise is less about devolved power and more about the devolution of risk and the associated, potentially negative, effect on services. …

… In 2016, there is no such thing as the UK housing market, rather a polarised collection of divergent, individual markets (hyper-dynamic price inflation in London versus low demand and price stagnation in parts of Liverpool & East Lancashire, for example) bearing little or no resemblance to the situation at the time of the last revaluation some 25 years ago.
The effect of this is an increasingly unfair council tax banding where a resident in Blackpool in a Band A property currently pays 35% more in council tax than a resident in a Band A property in Kensington and Chelsea, where average gross earnings are more than double that of those living beside the Pleasure Beach. …

… So far, devolution has only served to deflect risk and responsibility for the local effect of national cuts and add a further layer of complexity to an already intractable local government governance system. The lack of real power in devolution deals to date does not fully equip places or the incoming City Mayors to effectively deal with the challenges of the modern economy whilst driving tax revenue.

Without true devolution of power, the potential contribution of local government towards a prosperous future for people and place is in danger of drowning in a mire of unnecessary fiscal constraints and excessive levels of localised risk.”

http://www.cles.org.uk/wp-content/uploads/2016/11/CLES-Think_Devolution-Beyond-the-rhetoric_Nov-2016.pdf

Retired Cornwall GP: undemocratic and secret plans bad for Cornwall and Derriford Hospital

Radical cuts to Westcountry health services are being planned without consultation and in a rush, says Dr Jan Macfarlane. In an open letter to Cornwall’s councillors she calls for the full plans to be made public.

“I am writing to you with regard to the NHS Sustainability and Transformation Plan (STP) which was due to be submitted to NHS England.

“Sustainability”, as I am sure you know, means a plan to eradicate the financial deficit in the short-term. “Transformation” means plans to provide a cheaper health service in the longer term. This means drastic cuts driven, not by a desire for health care improvement, but simply in order to balance the books.

Prior to 2012 there was no deficit. The current deficit has been caused by a deliberate political choice to under-fund the National Health Service.

Britain’s spending on its health service is falling by international standards and, by 2020, will be £43 billion less each year than the average spent by its European neighbours, according to research by the independent King’s Fund.

Devon’s plan is already in the public domain and includes the loss of 400 acute beds, the loss of 190 community beds, and an 11% cut in the nursing workforce. “Consolidation of services” means that North Devon District Hospital will lose maternity neonatal and paediatric services and possibly acute stroke services.

The pressure group Save Our Hospital Services (SOHS) is mounting public opposition in North Devon and has a good Facebook page and website. Clearly this is of great interest to us in East Cornwall because 20% of Cornwall’s citizens access their secondary care from Devon.

Derriford Hospital is already struggling to cope with the workload and is frequently on “red alert” with bed shortages. It must now absorb much of North Devon District Hospital’s workload.

In Cornwall the deficit is £140million for 2016/17 and will be £277million by 2020/2021.

The draft outline Sustainability and Transformation Plan for Cornwall gives little detail as yet but the main thrust is out-of-hospital care and we can expect this means closing beds. More patients are to be looked after in the community but interestingly, according to their own document, 30% of GPs in Cornwall are planning to retire in the next three years.

Nationally there has been a 28% reduction in district nurses since 2009 and local authority spending has fallen by 17%, while the number of people over 85 has risen by 9%.

In the light of this the aspiration to keep people out of hospital seems somewhat optimistic and much of the burden is likely to fall on unpaid carers. The plans envisage “a few urgent care centres… in place of a multitude of unsustainable minor injury units”. There is likely to be a sell-off of estates and a reduction of the workforce.

Councils have been asked not to publish these Sustainability and Transformation Plans (STPs) and they are due to be signed off on December 23, just two days before Christmas – an excellent time to bury bad news.

The result of this secrecy and timing is likely to be that there will be insufficient public consultation and no time for the public to organise against the cuts.

The geographically based “footprints” are an undemocratic de facto extra-legislative reorganisation which has not been subject to the scrutiny of Parliament, as all previous health service reorganisations have.

I am asking for your help in ensuring the Sustainability and Transformation Plan (STP) plans are published as soon as possible and that Cornwall Council’s health oversight and scrutiny committee do not pass the plan without extensive and meaningful public consultation.”

Dr Jan Macfarlane is a retired GP from East Cornwall

http://www.plymouthherald.co.uk/issue-health-cuts-planned-in-8216-secrecy-and-haste-8217/story-29924066-detail/story.html

Why is Tiverton Community Hospital retaining 32 beds when some other community hospitals are being closed?

Apparently, as explained at a recent consultation, it is run as a Private Finance Hospital (PFI) and its contract cannot be broken.

So the rest of our district has to lose beds to keep it at its full capacity, even if that is too high.

Not what we want to hear.

Here is a Daily Telegraph article from 2015 explaining the situation:
http://www.telegraph.co.uk/news/nhs/11748960/The-PFI-hospitals-costing-NHS-2bn-every-year.html

What is a “health hub”?

Our CCG is telling us a lot about how “health hubs” can replace community hospitals.

But does anyone realise that they are a mixture of NHS and private services?

Here is how one “health hub” in Macclesfield, Cheshire describes itself:

Our Services

Macclesfield Health Hub is a collaboration between Vernova Healthcare and East Cheshire NHS Trust and is dedicated to enhancing patient choice and offering the highest standards of care.

The twelve consulting rooms at Macclesfield Health Hub are finished to a high clinical specification and the centre is conveniently located with excellent public transport links, next to the Waters Green Medical Centre.

Consulting and treatment rooms are available to hire on a sessional basis and provide a fully serviced offer. This includes reception for your patients, booking services, basic consumables, patient payment processing and high quality waiting and treatment facilities.

You can use our reception space for marketing your service and our helpful reception staff ensure that your patients are well looked after during their visit.

We can offer appointments during the evenings and on Saturdays as well as during the week, minimising the time you need to take off work or school.

NHS treatments are free and you can pay for private appointments on a pay as you go basis or for a course of treatment. Appointments last for 30 minutes and and there is public parking nearby.

You can relax in our welcoming centre with confidence that you are receiving the highest standard of care.

We are open from 8:00 to 21:00 Monday to Thursday and from 9:00 to 17:00 on Friday and Saturday.

We are situated close to the train and bus stations in Macclesfield”

NHS? All services free at the point of care? Definitely not – NHS patients will no doubt be encouraged to pay for a range of private treatments on site.

Section 106 scandal: New controls and a surprising revelation from CEO Mark Williams

S106 Funds and EDDC Audit & Governance Committee – report from an attendee:

On Thursday November 17th the Audit & Governance Committee of EDDC voted to make several changes to the Council’s finance systems which will now ensure that s106 payments will go to the local community amenities for which they are intended.

S106 payments are agreements under the Town and Country Planning Act 1990, often referred to as ‘developer contributions’ whereby developers agree to make financial contribution to the community infrastructure when they build property. These contributions are usually used to provide amenities such as playground equipment or other local projects, and usually decided with local councillors in the town or parish councils.

The recommendations to make changes in the way EDDC manages and monitors the s106 monies comes from auditors KPMG who received an objection from a local elector. KPMG mounted a financial investigation into the elector’s complaint and concluded that the council’s control systems had the following weaknesses:

1. An absence of summarised financial information to facilitate the monitoring of s106 contributions

2. Lack of challenge or enforcement of the developers’ legal obligation to provide information

3. Lack of understanding of financial and accounting implications of triggers being met and the communication between Planning and Finance over this.

EDDC Chief Executive Officer Mark Williams, at one point in the discussion, disclosed that he watches some s106 debts grow (because interest at 4%+ base rate is applied) rather than collect them when due so that the council can gain more money.

No one challenged or questioned the ethics of this as a strategy for dealing with the funds that could have gone sooner to the communities for which it is intended (or whether developers could be benefitting by delaying payments). Neither was it established whether that interest earned is applied to the s106 amenities for the community or left in the council’s general reserves.

EDDC Monitoring Officer Henry Gordon Lennox, referring to the £730,000 he had previously disclosed (through a Freedom of Information query) was owed in 2014/15 and 2015/16 for s 106 payments, interjected that the £730,000 owing had included a mistaken overstatement of £409,000. The current status of the other £321,000 was not established during the committee discussion however.

The auditors, in upholding the objection to the accounts, made Priority One recommendations to address each area of weakness because these are fundamental and material to EDDC’s systems of financial controls. The committee resolved that these should be implemented by set dates and KPMG will follow up in their next audit.

Councillors of various political parties during the discussion on this item thanked the elector for having raised the lid on this issue. Now that the previously weak system has had “a light shone on it” and addressed, the Audit & Governance Committee will be able to require regular reports on s106 monies owed and collected. They will be able to ensure that the funds are being directed to and spent on the amenities in towns and parish council communities projects for which they are intended.

Budget reality check: housing and infrastructure

Interesting that when talking about geographical inequities in the budget, the writer speaks only of the north and not the south-west.

“… As for housing, Whitehall policies remain dictated by the all-powerful builders’ lobby, craving state subsidies to increase demand and push up prices in the south-east. Hammond pledged £1.4bn for 40,000 “affordable” homes, which appears to be just £35,000 each. This is despite overwhelming evidence that Britain’s key housing resource is buried in the inefficient distribution of what is already built. The need is for smarter regulation of the existing housing stock, not more subsidy. On that, the modest new controls on rental fees are at least welcome.

Hammond had sadly inherited his predecessor’s infatuation with the great god, infrastructure. To George Osborne it was nothing short of Stalin’s “electrification of the Soviet Union”. This is despite the fact that most infrastructure is code for investment demanded by the private sector from the public sector. It is a welfare state for capitalist fast-learners.

To any chancellor, infrastructure is a gift. It is headlines today, and postpones payment until tomorrow – if not the day after. A Centre for Policy Studies report excoriates the wildness of this spending. It points out that half of China’s boom in infrastructure is now reckoned to harm growth. In Britain state capital spending is virtually uncontrolled, because it is buried in future debt. Hospital PFIs have saddled the nation with a staggering £200bn in debt. The McKinsey consultancy estimates rail projects on average go 44% over budget, and exaggerate their benefits by 50%.

Hammond this week boasted he would spend £1.1bn on roads, a genuinely pressing need. But it is ludicrously paltry, at one fiftieth of what he is about to spend on a single, upmarket railway line, the glamorous HS2. There are a dozen more worthwhile rail projects languishing. How can Hammond possibly tell health carers or the poor he is penniless? Infrastructure is political eye candy.

In his speech the chancellor rightly drew attention to the “damaging imbalance in economic growth across the whole country”. He went further, adding that “no developed economy has such a gap between its capital city and its second and third cities”. So what does he mean to do about it?

The latest Legatum prosperity index puts Britain near the top at creating prosperity, but not so good at sharing it. This is despite a not ungenerous welfare state. The reason is that sharing is not just about fiscal transfers. It reflects a deep imbalance of the country’s economic geography.

Nothing the government does is relieving this imbalance. Cities in the north of England are among the most poverty-stricken in western Europe. Their jobs flee to the south-east, followed by their young. Their local government is as indigent as their population. Media hysteria about housing and health is in reality about housing and health in the capital.

If the northern economy is depressed, London’s must be the most overheated in Europe. Yet Hammond heats it even more. He tips housing subsidies into the south-east. He spends ever more on transport in the south-east. He does nothing to decentralise public sector employment to the north. Subsidies for universities, charities and the arts are concentrated on London.

The government’s four megaprojects – Heathrow, HS2, the Oxford-Cambridge expressway and the forthcoming Crossrail 2 – are massive, and all in the south-east. They hurl public money at the wealthiest parts of the country. This merely piles pressure on housing, schools and welfare in the south-east. As for HS2, every study of high-speed rail indicates that it benefits the richer end of the corridor.

Britain’s greatest historical investment in housing and welfare is in the towns and cities of the north of England, Wales and Scotland. Houses lie empty, schools unused. Unless the government intends this to go to waste, rotting into a dependency culture and dragging down the rest of the economy, it must find ways to revive it.

Making it easier for Birmingham to get to London is not a national priority, getting fast from Manchester to Leeds is. Crossrail is not a priority, cross-Pennines is. Boosting London’s outbound tourism with more runways is not a priority, boosting northern tourism is. London does not need more bridges, the north’s ports most certainly do.

Hammond should tax London more heavily and the north more lightly. He should move London’s universities and research institutes to the provinces. He should beautify northern cities. This has nothing to do with Brexit, except that rebalancing the economy is an essential response to Brexit’s challenge. Relying on London as the nation’s workhorse is fair neither on London nor on the provinces. It is certainly not sensible.

https://www.theguardian.com/commentisfree/2016/nov/24/philip-hammond-britain-regional-imbalance-risky-autumn-statement