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
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.
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.
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.
Wednesday 21st December 18.00 – 20.30 at the Mackarness Hall, High Street Honiton EX14 1PG
The full list is at:
Vox Political blog:
“Theresa May consolidated her position as the UK’s most pathetic excuse for a prime minister yet, with a crushing defeat at the Dispatch Box under the questioning of Labour leader Jeremy Corbyn.
(Wasn’t he supposed to be the inept one?)
Mr Corbyn made strong points and supported them with solid facts. Mrs May provided no answers and seemed utterly lost.
Mr Corbyn began: “The government’s sustainability and transformation plans for the National Health Service hide £22 billion of cuts from our service, according to research by the BMA. That risks ‘starving services of resources and patients of vital care’. That comes from Dr Mark Porter of the BMA. When he calls this process a mess, where is he wrong?”
Mrs May ventured this reply: “The National Health Service is indeed looking for savings within the NHS which will be reinvested in the NHS. It is this government which is providing not just the £8 billion which the NHS requested, but £10 billion of extra funding… and sustainability and transformation plans are being developed at local level, in the interests of local people, by local clinicians.”
Oh really?
“It’s very strange the prime minister should say that,” mused Mr Corbyn. “Because the Health Select Committee… says it is actually £4.5 billion, not £10 billion. There’s quite a big difference there.”
So she was being economical with the truth about the amount of money being put into the NHS – and, by the way, is that NHS England or the health service across the whole of the UK? Mrs May doesn’t seem clear about that and the UK Statistics Authority certainly seems confused.
Mr Corbyn continued: “Part of the reason for the strain on our National Health Service is that more than one million people are not receiving the social care that they need. As a result of this there has been an increase in emergency admissions for older patients. What action will the prime minister take to stop the neglect of older people, which ends up forcing them to take A&E admissions when they should be cared for at home or in a care home?”
Mrs May: “The government has introduced the Better Care Fund… the Social Care Precept for local authorities, and we’re encouraging the working together of the health service and local authorities, to deal with precisely the issues he’s raised on social care and bed-blocking,” Mrs May blustered, unaware of the hammer-blow that would shatter her protestations very shortly.
She blundered on: “But I will just say this to the Right Honourable gentleman: Er, we’ve introduced the Better Care Fund and the Social Care Precept. Let’s just look at what Labour did in their 13 years. They said they’d deal with social care in the 97 manifesto, introduced a Royal Commission in 1999, a Green Paper in 2005, the Wanless Review in 2006, said they’d sort it in the CSR of 2007, and another Green Paper in 2009. Thirteen years and they did nothing.”
Here comes the hammer: “As the prime minister well knows, health spending trebled under the last Labour government – and the levels of satisfaction with the National Health Service were at their highest ever in 2010. This government’s choice was to cut social care by £4.6 billion in the last Parliament, at the same time as they found the space, shall we say, to cut billions in corporate taxation bills. That means it’s affecting patients leaving hospital as well. In the last four years, the number of patients unable to be transferred from hospital due to the lack of adequate social care has increased by one-third.”
So it doesn’t matter what Theresa May says her government has introduced; the service it provides is much, much worse than that offered under the last Labour government. That is unquestionable.
Mr Corbyn pressed on: “Will the prime minister ensure her government guarantees all of our elderly people the dignity they deserve?”
“I recognise the importance of caring for elderly people and providing them with the dignity they deserve,” said the prime minister, immediately prior to evading the question completely, going back over her previous assertion and changing the subject (which, as we all know, is a false argument).
“He says this government has done nothing on social care. I repeat, this government has introduced the Social Care Precept, that is being used by my local authorities and by his local authority, and we’ve also introduced the Better Care Fund.” That’s the recapitulation of what she had already said.
Let’s look at that Social Care Precept. It allows local authorities to increase council tax by up to two per cent in order to fund adult social care, meaning that this service has now become a postcode lottery.
Oh, and the Social Care Precept was announced at the same time the Conservative Government said the local government central grant is to be cut by more than half, from £11.5bn in 2015/16 to £5.4bn in 2019/20, a drop of 56 per cent. Meanwhile, councils were expected to increase self-financed expenditure (from revenue and business rates) by 13.1 per cent over the same period, making council services another postcode lottery.
Was it wise of Theresa May to draw attention to this monumental increase in unfairness across the UK?
The Better Care Fund is a pooled budget, initially £5.3 billion, announced in the June 2013 Spending Round and intended to save £1 billion by keeping patients out of hospital. As the number of patients who could not be transferred from hospital due to inadequate social care has increased by one-third in the last four years, it is clear that the Better Care Fund has failed.
In fact, the Chartered Institute of Public Finance and Accountancy and the Healthcare Financial Managers Association surveyed the plans for saving money through integration financed by the BCF in December 2015 and concluded that 80 per cent were likely to fail and that many were hampering progress, “giving integration a bad name”.
Mrs May continued: “But if he talks about support for elderly people I would remind him: Which government is it that has put the triple-lock in place for pensioners, that ensured the largest increase in pensions for elderly people?” And that’s the change-of-subject. Mr Corbyn was not discussing increases in pensions for senior citizens who may be perfectly healthy.
Our verdict can only be that, even though Mr Corbyn didn’t actually say the Conservatives have done “nothing” on social care, the result of their efforts is in fact worse. His response – “The precept is a drop in the ocean compared to what’s necessary for social care” – is mild, in that context.
Moving on to specifics, Mr Corbyn said: “I’m sure the whole House will have been appalled by the revelations in the BBC Panorama this week, showing older people systematically mistreated. The Care Quality Commission’s assessment is that care homes run by the Morleigh Group require improvement and has issued warning notices. The commission goes on to say that the owner has allowed services to deteriorate further, and has ‘utterly neglected the duty of care to the residents of these homes’. What action is her government going to take to protect the residents of those homes?”
Look at this stuttered, barely-intelligible response:
“The- the- Right Honourable gentleman mentioned-raises the issue of the quality of care that is provided in homes and the way that elderly people are treated. I’m sure everybody is appalled when we see examples of poor and uh, uh terrible treatment that is given to elderly and vulnerable people in care homes.
“What we do about it is ensure that we have the CQC which is able to step in, which takes action, which has powers to make sure that nobody-nobody in the chain of responsibility is immune from legal accountability. But we know that there’s more that can be done, and that’s why the CQC is looking into ways in which it can improve its processes, increase its efficiency.
“The, er, my-my honourable friend Minister for Community Health and Care is going to be writing to the CQC shortly, to look at how we can improve, to see what they do. It’s the CQC that deals with these issues. Is there more we can do? Yes, and we’re doing it.”
In other words, her government is taking no action at all.
Oh, and the CQC? It deliberately suppressed an internal review that meant it was found unfit for purpose in 2013. Are we sure we want to trust this organisation now?
“Yesterday, the government proposed that patients may have to show passports or other ID to access non-emergency healthcare,” said Mr Corbyn. “Has the government considered the impact of this on elderly people?
“The last census showed that nine-and-a-half million people in this country don’t have passports. Rather than distracting people with divisive and impractical policies, could the prime minister provide the NHS and social care with the money that it needs, to care for the people who need the support?”
Mrs May’s response was very silly indeed: “Over the course of this Parliament, the government will be spending half a trillion pounds on the National Health Service.”
And it is clearly not enough! How much goes into the pockets of private health bosses?
“The Right Honourable gentleman asks about a process to ensure that people who are receiving NHS treatment are entitled to receive NHS treatment. For many years there has been a concern about health tourism, about people turning up in the UK, accessing health services, and not paying for them.”
No, there hasn’t!
Oral Answers to Questions – Foreign and Commonwealth Office: Topical
Questions (22 Nov 2016)
https://www.theyworkforyou.com/debates/?id=2016-11-22a.747.2&s=speaker%3A11265#g751.0
Hugo Swire: All countries of the EU, with the exception of the United
Kingdom, have resumed direct flights to Sharm el-Sheikh, which are so
vital to the Egyptian economy. What more do the Egyptian Government
have to do to persuade the Government to resume direct flights?
“Hammersmith & Fulham Council has threatened legal action over proposals contained in the North West London Sustainability and Transformation Plan (STP).
The local authority described the STP put forward by NHS bodies as “flawed”, saying the report still had “the demolition of Charing Cross Hospital, and the sale of much of its site, as a key part of their scheme”. The council said it had “totally rejected this plan”.
Hammersmith & Fulham is to host a public meeting next week (29 November) at Hammersmith Town Hall.
Cllr Stephen Cowan, the council’s leader, said: “For the last two years, this council has been fighting alongside residents to save Charing Cross Hospital from proposals to demolish it and replace it with an Urgent Care Clinic that would be just 13% the size of the original hospital.
“We commissioned a public inquiry led by Michael Mansfield QC that has provided a strong evidence base for why the proposals are wrong, and have this week started official proceedings to stop NHS bosses closing our hospital. If they don’t listen, we will go to court.
“But now more than ever, we need all our residents to demonstrate the strength of local support to save our hospital.”
EDDC Tories have released the following statement and press release below.
The wording of this statement seems to imply to Owl that our local Tories are 100% behind the cutting of beds and the closure of our community hospitals. Note that it takes no account of the warning bells from the King’s Fund (plans are vague, poorly costed and badly evidenced) and the UK Statistics Agency (the NHS is underfunded) – it simply offers knee-jerk pandering to a CCG shown to be not fit for purpose and (much as usual in Devon these days) with people at the top with glaring conflicts of interest.
THE STATEMENT
“We have decided as a group to issue this statement on the proposed bed closures throughout Devon which we will continue to oppose in their current form. Those wishing to cause mischief are doing a great disservice to our residents as they do not offer a sustainable solution to the endemic problems the NHS faces and tinkering with the process is no solution to the root and branch reform needed. The process is being piloted in Devon and Sir Hugo Swire and Neil Parish, our MPs, are continuing the fight in Westminster as do I as the South West Board Member for the District Councils Network nationally and as a Member of Devon County Council’s Health and Wellbeing Scrutiny Committee.”
Readers will recall that Councillor Leader Diviani voted against DCC Councillor Claire Wright’s motion to “stop the clock” on the closure of Honiton hospital until its viability had been reassessed and rechecked. Councillor Leader Diviani and his fellow Tories can hardly claim to be defending our services – indeed they seem anxious for the process to be concluded as quickly as possible, including the closure of Honiton hospital.
They also state that our MPs are “fighting for us” when their voting records, lack of speeches on our behalf and watering down of a parliamentary motion shows that they are doing nothing of the sort.
To all those vulnerable people out there who will suffer from these cuts: use your vote much more wisely in council by-elections, elections and general elections.
Now, compare what they say in the paragraph above to the press release sent out below. REMEMBER, when they say THEY – they mean their own party!
THE PRESS RELEASE
STARTS
“Conservatives call for second opinion on Devon NHS funding crisis treatment
ENSURE THAT BED-CUT ‘CURE’ DOESN’T DAMAGE PATIENTS
East Devon Conservatives are deeply worried about proposals from the NEW* Devon Clinical Commissioning Group to restructure hospital care in the North, East and West of the county in a bid to plug a £400 million budget shortfall over the next three years.
They believe the hospital bed closures proposed by the Devon health provider as the cure for a funding crisis may be the wrong treatment – and could have harmful side-effects for patients.
So the 37 Conservative members of East Devon District Council are sending a collective response to the CCG’s current consultation in the hope of persuading the NHS commissioning group to change its approach to tackling the immediate £100m funding gap, expected to rise to £400m by 2020.
The Conservative councillors are advising the CCG that it would be dangerous to move from a system of mostly inpatient treatment to care at home until a robust structure is in place to provide the alternative cover. Taking this step without the necessary resources in place and with no vital transition budget to call upon, could put patients at risk, they say.
Dangerous
Having studied the CCG’s report, Conservative group members were unimpressed with the strength of the argument in favour of bed closures and home care, especially because the CCG has not been able to provide accurate and meaningful financial detail or convincing trial evidence to back up its proposed Community Care Package.
They also wonder if the massive funding gap could not be closed by greater attention to efficiency savings.
And they are counselling the commissioning group not to adopt a “one-size-fits-all” approach to tackling the area’s financial ills, bearing in mind the differing demographics and age profiles of each local authority area in Devon, especially remote rural communities. Patient vulnerability and loneliness must also be addressed.
The CCG appears to favour a new model of care that has been subject to limited testing, with little hard evidence that it improves the service to patients.
The Conservative group are not convinced by the scant evidence provided after their requests for more detail and are nervous of the CCG’s reliance on a notional target of county hospital beds, regardless of variations in proven need.
Blunt instrument
They want to know more about the 80 clinicians the CCG claims to be in support of the new model. And they are sceptical of a ‘blunt instrument’ approach to treatment, especially when many elderly patients have dementia in addition to multiple clinical problems.
Finally, the Conservative members contest that many areas in East Devon appear to have a reducing stock of nursing and residential home beds. This only aggravates the situation, because these beds are often required in the short or long-term for patients stuck in hospital.
Phil Twiss, Conservative Group Secretary, said: “Some people want to boycott this consultation process – but that won’t help anyone. We believe constructive feedback is the best way.
“We all agree that bed-blocking is a serious issue and we also accept that the clinical commissioning group need to save money. The question is how should they go about it so as to deliver results without making the situation worse.
“We feel that they have the solution the wrong way round. They want to move to a care-in-the-home model at a time when the resources just aren’t there to support that model. It might be the right approach in theory, but it will only work in practice if the social care infrastructure is robust enough to take the strain – and it is not.
Panic measures
“We’re not convinced that the new model has delivered the right standard of success in trial areas and we don’t believe it can be rolled out across other parts of the county until the necessary support structure is in place. And we should not be moving to a new model as a panic measure to solve a funding shortfall that could be tackled by other means.
“For example, a lot of money can be wasted on high-cost agency staff who appear to be a short-term emergency man-power fix but all too often are relied upon as part of the workforce establishment.
“We don’t know whether the budget shortfall was perhaps caused by wasteful practices that are still in place, and so we don’t know whether the CCG could find alternative ways to save money. What we do know is that their current proposals are unconvincing and ill-advised”.
East Devon Conservatives will be responding to the CCG consultation with their views and will be calling on the commissioning group to think again.
ENDS
SO, are they for cuts or against them? A dangerous business deciding which bit is truth and which bit is post-truth!
Blog comment reposted verbatim:
How ironic – on the same day that the UKSA says the figures are wrong and misleading the HoC Tory majority debates NHS funding and makes a formal statement.
In yesterdays NHS funding debate neither Neil Pariah nor Hugo Swine said anything. See
https://www.theyworkforyou.com/debates/?id=2016-11-22a.820.0&s=speaker%3A25120
But there was a vote about what the HoC wanted to say about the funding crisis. The original text was:
That this House notes with concern that the deficit in the budgets of NHS trusts and foundation trusts in England at the end of the 2015–16 financial year was £2.45 billion; further notes that members of the Health Committee wrote to the Chancellor of the Exchequer about their concerns that Government assertions on NHS funding were incorrect and risked giving a false impression; and calls on the Government to use the Autumn Statement to address the underfunding of the NHS and guarantee sustainable financing of the NHS.
However the Conservatives voted to change this to:
That this House welcomes the Government’s investment, on the back of a strong economy, of significant additional funding and resources each year for the NHS during the 2015 Parliament; notes that this settlement was frontloaded at the specific request of the NHS in NHS England’s own plan to deliver an improved and more sustainable service, the Five Year Forward View; and further notes that the NHS will receive a real terms increase in funding in each year of the Spending Review period, while the Labour Party’s Manifesto at the last election committed to only an extra £2.5 billion a year by 2020, far less than the NHS requested.
And both Neil Pariah and Hugo Swine voted for the revised text, turning a call for increased funding into a sycophantic statement about how wonderful the Government is funding the NHS.
So next time either of our MPs say how concerned they are about the NHS and how they will fight for extra funding (like Hugo Swire said in Pulman’s only yesterday) you should consider carefully whether they are really fighting for extra funding or simply paying lip service (or as we commoners might say “lying”) in order to keep your votes.
“The UK Statistics Authority looked into the prime minister’s repeated use of the £10bn claim after Labour and the British Medical Association complained that the figure was misleading and wrong. It has asked the Treasury to overhaul how government spending on both the NHS and health more widely is presented in order to minimise the risk of further “confusion” about the size of budget rises.
The UKSA’s intervention followed an increasingly public disagreement between May and Simon Stevens, the chief executive of NHS England, over how much extra funding the government had pledged to give the health service over the course of this parliament. May has put the figure at £10bn in the House Commons, a newspaper interview and at the Conservative party conference. She said that sum meant her administration was giving the NHS more money than the £8bn it had asked for in 2014 in order to transform how it works and close a £30bn budget gap by 2020.
Jon Ashworth, the shadow health secretary, accused the prime minister of exaggerating the true sum and using “spin” to try to present the government in a better light over the NHS. Dr Mark Porter, chair of the BMA’s ruling council, had also asked the UKSA to look into May’s claim. …
… The UKSA intends to ask the Treasury to “investigate whether in future they can present estimates for NHS England and total health sending separately. I will also explore with officials producing these figures other ways in which they might ensure clarity around sources, time periods and what is being measured, and in what context, when reporting on the level of increase in real budget allocations to NHS England.”
While Hunt has acknowledged that the £10bn was the budget increases over a six-year period, May has yet to do the same.”
Another week where the Midweek Herald’s contribution to the current debate on health service cuts is limited to two short readers’ letters. No news about recent public meetings, no news on forthcoming public meetings, no coverage on Councillor Leader Diviani voting against a re-examination of the case for closing Honiton Hospital.
Well, it isn’t that serious is it …
Owl’s summary: you haven’t done your homework, your models are untested, you don’t understand what you are doing and the NHS is underfunded NOT overspent!
Some quotes:
17. Plans to close the estimated £22 billion gap have not been fully tested.
“The Department, NHS England and NHS Improvement used a financial model to estimate the gap between patients’ needs and resources by 2020-21, and the savings their programmes need to achieve to close this gap. We found limited testing by the Department, NHS England and NHS Improvement of their estimates of how much they expect to generate from their savings programmes.
This raises concerns about whether planned savings can be achieved. For example, plans assume that growth in trusts’ acute activity (including specialised acute services) will be reduced from 2.9% to 1.3% through transformation and efficiency programmes such as Right Care, new care models and the Urgent and Emergency Care programme. However, NHS statistics show this will be challenging as hospital admissions, a key driver of activity, grew by 2.8% a year between 2013-14 and 2014-15 (paragraphs 2.4 to 2.7).”
18. The NHS is implementing its plans to make the NHS financially sustainable from a worse than expected starting point.
Plans to achieve financial sustainability were based on trusts ending 2015-16 with a combined deficit of £1.8 billion. The fact that trusts ended the year with an even larger deficit means that the level of deficit to be recovered is significantly greater than expected. This means that the trusts affected will need to catch-up by making more savings than planned to reach the intended starting position. For example, trusts with deficits greater than expected at the end of 2015-16 will need to make operational efficiencies above the 2% savings level applied to all providers of healthcare services in 2016-17 or subsequent years (paragraphs 1.8 and 2.8).
19. National bodies have not assessed the impact of all the wider cost pressures faced by local NHS organisations in plans for achieving financial sustainability.
The Department, NHS England and NHS Improvement expect trusts and commissioners to invest in transformation programmes. But they do not yet know what level of investment is required or whether local bodies will be able to make the changes at the scale and pace needed.
Furthermore, the government has made a commitment that the health and social care system in England will be fully joined together by 2020. We have previously reported that local authority spending on adult social care fell by 10% in real terms between 2009-10 (£16.3 billion) and 2014-15 (£14.6 billion). The accounting officer for NHS England told the Committee of Public Accounts that “over the next two or three years, there is likely to be a widening gap between the availability of adult social care and the need for social care. That, will, inevitably show up as delayed discharges and extra pressure on hospitals.” However, in our review of the plans for financial sustainability, we did not see any estimate of the impact of pressures on social care spending on NHS bodies (paragraphs 2.6 to 2.13).
24. The National Audit Office (NAO) perceives differences in the position articulated by the Department – which views the funding for the NHS as having been adequate over the last few years, and in line with what NHS England set out it would need to deliver the NHS Five Year Forward View – and NHS England itself. Confronted as NHS England is by the pressures of rising demand for services, these signs of differences do not help build a confident feel about the future of the NHS.
https://www.nao.org.uk/report/financial-sustainability-of-the-nhs/
Japan has the largest population of people over 65 (25%). All sorts of theories about why the elderly are committing more major and minor crimes but an interesting point made about those imprisoned for their crimes:
“Thousands of [elderly people] are winding up in prisons. National police figures for 2015 show the number of people age 65 and older arrested for criminal offenses makes up 20 percent of all arrests, which totals nearly 48,000.
The Japanese government is spending tens of millions on constructing prison wards specifically designed to cater to a growing number of elderly inmates. But Shinko warns that nicer prison facilities might have the opposite effect of deterring crime.
If you steal and get away with it, you end up with free groceries or money.
But “If you are arrested, you still get a roof over your head, you’re fed three times a day and you get health checkups. So it’s sort of a win-win situation either way,” says Shinko.
It’s a vexing policy problem for Japan, and a glimpse of yet another difficult challenge as more and more of its population ages past retirement.”
Strange that! You might think they would need to know what is happening, what has been spent so far and what is to be spent in future.
Yet no mention of funding changes at their last meeting in September
Click to access 150916erpbcombinedagenda.pdf
when officers and senior councillors were almost certainly aware of the problem. Or was that the ” more thoughtful approach” mentioned in the minutes!
Perhaps EDDC just has an open chequebook approach.
Here is what they DID report about Queen’s Drive:
“RC (Richard Cohen) gave an update on the Queens Drive development. It was noted that agreement had now been reached with tenants. There was a meeting next month with Grenadier and there was enthusiasm that the project was moving forward. It was hoped that planning permission would be in place for Phase 2 of the project by the end of the calendar year.
It was reported that a more thoughtful approach could be taken towards Phase 3 of the project and take steps to take this to the market. There was a need to go out to public consultation on Phase 3 o the works and also go out to tender.
Agreement had been reached with the tenants of Harbour View Cafe to end the formal lease and they were currently on licence until the end of September. A request had been made to leave the tenant in situ until the Council needed the site for redevelopment works. The Board members were keen that the building was not left vacant and the tenant remains in situ.
TW (Tim Wood) expressed his disappointment that a cafe/restaurant had not been established at Orcombe Point.
JME (Councillor Elson) raised the issue of having a Master Planning meeting of all /Exmouth District Councillors on Monday 12 September at 6.00pm.”
Politics in Burma:
https://www.theyworkforyou.com/wrans/?id=2016-11-16.53464.h&s=%22east+de
Still can’t accept that he was fired from the Foreign Office it seems
and traffic noise:
Written Answers – Department for Transport: Motor Vehicles: Noise (21
Nov 2016)
https://www.theyworkforyou.com/wrans/?id=2016-11-15.52910.h&s=speaker%3A
11265#g52910.q0
Hugo Swire: To ask the Secretary of State for Transport, what steps his
Department is taking to reduce noise emissions from (a) motorcycles, (b)
cars and (c) commercial vehicles; and what targets he has set to reduce
each such type of noise emission.
Maybe boy racers outside his Mid-Devon home or all those HGV’s for the construction traffic for basement conversions near his Central London home?
With the proposal to severely cut community hospital beds and totally close some community hospitals (Owl STILL insists a ” community health hub” with no beds is NOT a hospital) comes some interesting behaviour from majority party councillors in East Devon.
For example”
Suddenly, they have become “experts” on consultation, loudly stating that the CCG consultation is “flawed” because users of NHS services were not consulted.
They check numbers and find some don’t add up and some are missing.
They ask for “more evidence” on some of the CCG’s wilder claims.
They suddenly discover their voices and some, who have been mute for many a long month or even years, decry the whole project – even though their own party is 100% responsible for it.
They complain bitterly about the amount of money spent on so-called consultants who seem ready to tell the CCG what it wants to hear – for a price.
Well, councillors, welcome to our world – the world of residents battling some of YOUR sillier decisions (so many of them) and profligate spending. Now YOU know how WE feel – if only for a fleeting moment and because it is YOUR health and YOUR families that will suffer from these decisions. Especially as so many of our majority councillors are of the age and lifestyle that often makes most demand on community hospital services.
Just one caveat: Councillor Leader Diviani HAS stayed true to his principles and has tacitly agreed to CCG proposals to close Honiton hospital – having not spoken out AND voting against the motion from Councillor Claire Wright at DCC to “stop the clock” on the plans until Honiton and Okehampton hospitals (both due to close under CCG proposals) could have their viability assessments checked and included in the plans.
Expect some rousing speeches when the head of the CCG comes before the EDDC Scrutiny Committee on Thursday this week at 6 pm. But do watch out for any majority councillors crossing their fingers behind their backs.
Yes, welcome to our world indeed – if only for a very short time.
PLANNING APPLICATIONS
A big thank you for all the emails of support that we have received in the last few days regarding the latest planning application for development proposals for the Friends Provident site. We are currently working our way through this latest planning application. Although we remain open minded to the eventual solution to the site, we currently have grave reservations regarding these proposals for Winslade Manor and the Stables because the developer hasn’t offered any solution to a number of key National Planning policies such as :
-The loss of the leisure facilities (Stables Club) that were closed down at the end of 2015
-The flooding that has continued to occur at the site and the proposals to build houses and industrial buildings in the areas that frequently flood. (As I am writing this email I have just been advised of the closure of the A376 due to flooding!)
-The fact that our village remains unsustainable for such a significant population increase, having only one shop and a pub
-Lack of public transport links and the scale of congestion that already occurs on a daily basis (set to be exacerbated by the poorly considered location to the entrance by our Village Hall)
-The proposed site sits outside of the current approved Built Up Area Boundary
These are just a few of the examples and valid reasons why the proposals won’t enhance our village; worryingly, the proposed scheme has many other areas where we have serious concerns.
We have started writing some template letters of objection which you may want to use. We hope to be able to email them to you within the next week. Moreover, we understand that the Parish Council may be arranging a Public Meeting at the beginning of December to further discuss the planning application. As soon as we get a date and time, you will be informed.
FOUL ODOUR
East Devon District Council’s Environment Department is currently conducting a survey of households within our neighbourhood regarding the odours that were omitted from Enfield Farm and the anaerobic digester. Hopefully, since the last major problem five weeks ago, things have considerably improved. We have been told that this should finally solve the ‘odour issue’ that has annoyed residents for so long.
This is a photograph purported to be from Cranbrook appearing on the Express and Echo website. Note the houses to the left of the image:
““Storm Angus has flooded the controversial new offices of the Devon and Cornwall police and crime commissioner.
Staff only moved in three months ago as part of a £500,000 renovation project of the suite at police headquarters in Exeter. But they’ve been forced to move out today. It’s thought leaves clogged drains on the roof, leading water to pour in.
A source told us there was considerable damage, and it wasn’t clear how long it would take before the offices would be in use again.”
BBC Devon live website
East Devon Watch 