Privatisation: some things to think about

1. Your services get worse

Private companies have a legal duty to reward their shareholders, so they have to prioritise making a profit. This means they may end up cutting corners, or underinvesting in your public services. Water companies ignore leaks instead of investing in infrastructure, while private company involvement in the NHS has been bad for patients. Private companies also have ‘commercially confidential’ contracts, so they don’t share information with others; this makes it harder for them to work in partnership to make services better.

2. Your costs go up

You pay more, both as a taxpayer and directly when you pay for public services. Value for money goes down because private companies must make a profit for their shareholders and they also pay their top executives more money. This means either we the people, or the government, or both, end up paying more. Fares on our privatised railways and buses are the most expensive in Europe, while people are also being hit with high energy bills. 57% of 140 local authorities surveyed in 2011 said they had brought outsourced public services back in-house or were considering it, with 60% saying that the main reason was the need to cut costs.

3. You can’t hold private companies accountable

If the local council runs a service, you know where to go to complain. But if a private company runs a service, they are not democratically accountable to you. That makes it harder for you to have a voice. Academy schools are less accountable to parents. Private company Atos tried to silence disability campaigners instead of responding to their concerns about work capability assessments. A report by the Institute of Government reveals problems in outsourcing public services, including a lack of transparency, manipulation of contracts by suppliers and a reluctance to sack underperforming providers.

4. Staff are undermined

If you work in public services, privatisation will make your life harder. A Europe-wide study found that privatisation has had ‘largely negative effects on employment and working conditions’. There are often job cuts and qualified staff are replaced with casual workers, who are paid less and have worse conditions. This has a knock-on effect on the service being provided – for example, in the cases of care workers or court interpreters.

5. It is risky and difficult to reverse

Once our public services are privatised, it’s often difficult for us to get them back. Not only that, we lose the pool of knowledge, skills and experience that public sector workers have acquired over many years. We also lose integration both within and across different public services. A Deloitte report finds that many large companies are bringing services in-house because of the costs, complexity and risks of outsourcing.

But wait!

Aren’t private companies supposed to be better than the public sector? Doesn’t competition reduce costs and improve quality and customer care? No, because there is often very little competition; public services tend to be natural monopolies so there isn’t much choice for consumers. Instead, government (local or national) asks private companies to bid for contracts running our services – but there’s no real opportunity for our voices to be heard.

https://weownit.org.uk/privatisation

Labour will not back a progressive alliance – the proof

“… Labour has stuck with the usual protocol. Its candidate is campaigning hard in Richmond Park, leading to fears that he will split the anti-Tory vote. At the local party’s meeting to select the candidate on 4 November, a member called Mike Freedman suggested that proceedings ought to be abandoned. He says he was interrupted by an official sent from the Labour party’s London HQ. “He said: ‘You can’t do that,’” Freedman tells me. “I said: ‘I can.’ He said: ‘Well, I won’t let you. I’ll stop you.’ And he said if we didn’t choose a candidate the party would impose one.” …”

https://www.theguardian.com/politics/2016/nov/28/is-progressive-alliance-only-way-stop-hard-right-populism

“False, flawed and fraudulent” says “Save Our Hospital Services” of NHS plans for Devon

SAVE OUR HOSPITAL SERVICES DEVON PRESS RELEASE
ON THE NATURE OF INDEPENDENCE AND IMPARTIALITY

The ‘Success Regime’/STP Team in Devon

“Save Our Hospital Services Devon (SOHS Devon) is today calling for the abolition of NHS England’s Sustainability and Transformation Plan (STP) for Wider Devon and the suspension of the so-called Success Regime for North, East and West Devon that is now an integral part.

“These two programmes are false, flawed and fraudulent,” says Dave Clinch, a spokesperson for SOHS in North Devon. “They are riddled with public-private, professional-personal conflicts of interest.”

SOHS Devon points out that the Case for Change document on which both the Success Regime and the STP are based was produced by a private-owned health service consultancy, Carnall Farrar. One of the consultancy’s founding partners, Dame Ruth Carnall, is now the ‘Independent’ Chair of the Success Regime pushing through the STP in Devon.

“SOHS Devon believes that there is a pre-determined agenda in Devon to cut services, limit access and reduce demand by redefining medical need to ensure that government cuts are carried out. How can Ms Carnall, who produced the blueprint for the STP, be considered remotely independent in assessing our needs or services to meet them?” asks Mr Clinch.

SOHS Devon points out that to push their agenda for cuts to NHS services and staff, the Success Regime/STP team will have been allocated £7.4 million between 2015 and 2017. Some of this funding has been used to recruit senior staff from those same services they plan to cut; for example, Andy Robinson, who left his role as Director of Finance at the Northern Devon Healthcare NHS Trust to join the Success Regime in Exeter. What is more, Mr Robinson happens to be the partner of the Chief Executive of the Trust, Alison Diamond.

“Professional or personal? How can this relationship avoid directly impacting on the life-and-death decisions now being made?” says Mr Clinch.

Meanwhile, the proposed relocation to Exeter of acute services based at North Devon District Hospital (NDDH) is being overseen by the Success Regime’s Lead Chief Executive Angela Pedder, the former CEO of the Royal Devon & Exeter Foundation Trust.

“How can she be considered unbiased given her former role?” says Mr Clinch. It’s no coincidence that RD&E needs to cover a much bigger deficit than NDDH in Barnstaple.”

On top of this, the two leads on the STP’s Acute Services Review programme are both from hospitals in South Devon, namely Derriford in Plymouth and Torbay in Torquay. SOHS Devon can find no evidence that they are talking to the clinicians working in acute services at NDDH. And the fact is, if the proposed acute services cuts go ahead, people here in North Devon will suffer and die”.

ENDS

Social care HAS collapsed

Readers are urged to read the full article, only part of which is reproduced below. Social care is NOT about to collapse – it HAS collapsed. In addition, the decision to hand health and social care budgets ( cut to the bone and beyond) means that, with what little help there is available, rich areas will get better care than poorer ones and there will be a postcode lottery for services – which will sometimes depend which side of a road you live on.

Theresa May is under intense pressure from senior doctors and a powerful cross-party alliance of politicians to avert a collapse in care for the elderly, as shocking new figures show the system close to meltdown.

The medical profession, together with Tory, Labour and Liberal Democrat leaders in local government, have demanded a funding U-turn, warning that the safety of millions of elderly people is at risk because of an acute financial crisis completely overlooked in chancellor Philip Hammond’s autumn statement.

New figures obtained by the Observer show that 77 of the 152 local authorities responsible for providing care for the elderly have seen at least one residential and nursing care provider close in the last six months, because cuts to council budgets meant there were insufficient funds to run adequate services.

In 48 councils, at least one company that provides care for the elderly in their own homes has ceased trading over the same period, placing councils under sudden and huge pressure to find alternative provision.

In addition, 59 councils have had to find new care arrangements after contracts were handed back by a provider who decided that they were unable to make ends meet on the money that councils were able to pay them.

The medical profession, council leaders and even the former Tory health secretary, Andrew Lansley, are appalled that the social care crisis – exacerbated by growing numbers of elderly people and the rising costs of paying staff – was not addressed in the autumn statement.

In a letter to the Observer, the leaders of the four main political groups in local government expressed their disquiet at the chancellor’s dismissing talk of a crisis despite calls from politicians, NHS leaders, doctors and others. …

See https://www.theguardian.com/society/2016/nov/26/nhs-elderly-care-close-to-collapse

PegasusLife jumps the gun …

There was a full page advertisement on the back page of yesterdays Property section of Telegraph for Pegasus with a list of “Developments coming soon” which includes Sidmouth!!

Owl in its innocence thought the DMC meeting this coming Tuesday would
make the decision.

But it seems PegasusLife knows things we don’t. … Nothing new there then.

It will be interesting to see how the DMC talks itself out of a decision very similar to the company’s development in Bath – which was very recently refused, in part because the way the company presented the development, it did not feel that it needed to make provision for affordable housing.

Current bed cuts in Devon hospitals – the reality

“The number of beds at a Devon hospital trust have fallen by more than a quarter over the past six years.

In July to September 2010, the average number of general and acute beds open overnight at Torbay and South Devon

The occupancy rate for these beds has grown from 64.6% in July to September 2010, to 87.7% in 2016, an increase of 36%, one of the highest in England.

At Northern Devon, the number of beds has also dropped by 21%, from 370 to 294, with occupancy rates rising from 85.5% to 86.4% over the same period.

Across England, for general and acute beds open overnight, the occupancy rate between July and September was 89.1%, up from 87% over the same period in 2015.

The average daily number of beds open overnight was 129,458 in July to September 2016 compared with 130,774 in April to June. The average occupancy rate for all beds open overnight was 87.5%.

Health experts advise that occupancy levels should ideally be under 85%. Anything over this level is regarded as riskier for patients as this leads to bed shortages, periodic bed crises, and a rise in healthcare-acquired infections such as MRSA.

Commenting on the numbers, Mr Ian Eardley, a consultant urological surgeon and Vice President of the Royal College of Surgeons, said:

“The NHS has been able to reduce bed numbers as medical advances mean more modern surgery can take place without an overnight stay. However, these figures suggest bed reductions have now gone too far in the absence of sufficient social care or community care alternatives.

“We are now seeing increasing numbers of frail older patients in hospital because they have nowhere else to go. The lack of additional money in the Autumn Statement for social care and the NHS is only going to make this even harder.

“Today’s figures will come as no surprise to frontline staff who struggle every day to provide for their patients because of increasing demands and a shortage of hospital beds. I and too many of my colleagues all around the country are regularly having to cancel patients’ operations due to a lack of beds and delays in transferring patients back into the community.

“A number of sustainability and transformation plans are proposing further hospital bed reductions. Today’s figures suggest NHS leaders need to think carefully about whether this is a good idea without first putting in place better care in the community.”

The Royal College of Surgeons warned the figures almost certainly underestimate hospital bed shortages in the NHS. The Nuffield Trust think tank warned last month that NHS England’s bed occupancy statistics do not show the true scale of the problem, stating that “with a growing number of patients coming and going during the day, counting bed occupancy at midnight means that crunch times are often invisible”.

http://www.exeterexpressandecho.co.uk/number-of-hospital-beds-in-devon-falls-creating-potential-risk-for-patients/story-29936995-detail/story.html

Let’s add the Royal College of Surgeons to that list of NHS change critics

“The Royal College of Surgeons has warned of a chronic shortage of NHS hospital beds in England, after occupancy rates for overnight stays topped 89% for a fourth successive quarter.

The maximum occupancy rate for ensuring patients are well looked after and not exposed to health risks is considered to be 85%, a figure that has not been achieved since NHS England began publishing statistics in 2010.

From July to September this year the percentage of beds occupied in wards open overnight was 89.1%, compared with 87% in the same period last year. That was the last time it was below 89%.

The RCS said the figures, published on Thursday, made for alarming reading and indicated a failure to cope with the increasing number of older patients in hospital.

Ian Eardley, a consultant urological surgeon and vice-president of the RCS, said: “The NHS has been able to reduce bed numbers as medical advances mean more modern surgery can take place without an overnight stay. However, these figures suggest bed reductions have now gone too far in the absence of sufficient social care or community care alternatives. …”

https://www.theguardian.com/society/2016/nov/24/nhs-hospitals-suffer-from-chronic-bed-shortage-surgeons-say

Donald Trump and Devon devolution – what do they have in common?

What they have in common is, now The Donald has won his election, he is involving his family, his own businesses and his cronies in his political appointments and “strategic” decision-making.

If we have an elected Mayor with vested interests in Devon or Somerset or Devon AND Somerset, what checks and balances do we have to stop the Mayor putting his or her own interests first like The Donald?

If we get a Mayor with Hinkley C connections can we be sure that, where a decision on Hinkley C conflicts with a Devon interest, the Devon interest will have equal weight? Or vice-versa if the Mayor is Devon-centric.

And what if the Mayor has allegiance to neither county – only a national interest as a developer, a developer’s friend or is a large developer’s shareholder. What then?

We all know of politicians and business people with dubious reputations. Few politicians and even fewer members of our Local Enterprise Partnership are trusted. Who can we trust to represent us all?

Now the well-regarded Institute of Fiscal Studies joins health row

Institute of Fiscal Studies”

Chancellor Philip Hammond will not be able to resist calls for extra funding for health and social care for much longer, the head of the Institute for Fiscal Studies has predicted. …

http://www.publicfinance.co.uk/news/2016/11/pressure-will-mount-health-and-care-funding-boost-says-ifs

They join:

The King’s Fund:

Which reported that changes were kept secret from doctors and the public:

http://www.independent.co.uk/life-style/health-and-families/health-news/hospital-closures-stps-secret-kept-nhs-ae-public-kings-fund-england-chris-ham-stp-a7415836.html

The National Audit Office:

Which reports that the NHS is underfunded:
https://www.theguardian.com/society/2016/nov/22/nhs-financial-problems-endemic-and-no-longer-sustainable-national-audit-office-deficit

and

The UK Statistics Agency:

which says numbers simply don’t add up including the purported £10 billion extra cash:

https://eastdevonwatch.org/2016/11/23/and-now-the-uk-statistics-agency-criticises-nhs-funding-figures/

Who disagree? Theresa May and Jeremy Hunt. Their plan? Cut, cut, cut – then privatise what makes money and keep cutting essential services don’t show a profit.

Moral of this story: Don’t get sick but do get angry!

Hernandez refuses TV interview on police 101 shambles

Report on Spotlight just now. People unable to get through to police non-emergency 101 number because it was being used for internal police administration:

http://www.bbc.co.uk/news/uk-england-devon-37553204

Hernandez refused to appear on the programme simply saying that she had “challenged the Chief Constable to make significant improvement to the length of time the public take to get through to someone”.

Well, that’s alright then.

Recall that Hernandez and the Chief Constable are currently under investigation by other forces – Hernandez for alleged electoral expenses violations in Torbay and the Chief Constable for unguarded remarks during a TV interview.

Hernandez has been banned by the Police and Crime Panel for making political statements. Presumably, this has left her almost mute.

“£7.4 million of NHS funds for ‘reorganisation’ in eastern Devon”

Does Project Omega (see post below) include profligate spending on NHS ‘reorganisation’ to bring it to its knees so it can be privatised?

Health bosses have come under fire for spending £7.4million of NHS funds on ‘reorganisation’ – that campaigners say could have gone towards frontline care.

The Northern, Eastern and Western Devon Clinical Commissioning Group (CCG) is identified as one of the most economically challenged in the country with a predicted £384million deficit by 2020/21.

In response to the crisis, the region was chosen to undergo a drastic ‘transformation’ led by the Success Regime, which is proposing to axe 71 community hospital beds as part of a series of cuts.

Campaigners have hit out at plans that would see Sidmouth lose its inpatient beds and said patients should not suffer as a result of badly-managed finances.

District councillor Cathy Gardner said: “I think it’s shocking that £7.4million can be found for reorganisation but not for frontline care. Many will question how wisely NHS funds are being spent when management consultants and internal managers are using up so much cash.

“Health and social care in Devon has suffered from chronic underfunding. The NHS does need serious reform but not of the kind being undertaken under the guise of improvements.”

The CCG confirmed that the Success Regime in Devon received £1.4million in 2015/16 and a further £6million in 2016/17 – but stated that the money was specifically set to implement changes and was not taken from the region’s £1.1billion budget for health services.

Campaigner and chairman of the Sid Valley patient participation group Di Fuller said: “The additional costs of managing the Success Regime, to try and put right what CCG management had failed to do, have diverted yet more funding from frontline services in the NHS.

“We must not endorse cuts to try and put this right until CCG can prove that alternative provision will be safe and meets quality standards.”

A CCG spokesman confirmed a total of £3.3million was spent on the Success Regime’s first phases of ‘transformation’ in Devon, Essex and Cumbria, with a further £17million budgeted for 2016/17. He added that the Success Regime’s programme aims to transform the way care is provided with a move towards a ‘home-based’ model of care.

This is expected to save between £4.7million and £7million a year after reinvestment into community services.

The CCG says it is continually looking at how to make the administration of care more efficient and streamlined.

http://www.sidmouthherald.co.uk/news/7_4_million_of_nhs_funds_for_reorganisation_in_eastern_devon_1_4791348

Destruction of the NHS planned in Thatcher era National Archive documents show -‘The Omega Project’

“… Another document in the National Archives outlines radical plans to end universal free healthcare.

The document stamped “secret” was called, in keeping with films and books of that era, “The Omega Project”.

Civil servants noted that “for the majority it would represent the abolition of the NHS”.

But in spite of what was described as the nearest thing to a Cabinet riot in the history of the Thatcher administration, the prime minister secretly pressed ahead with the plans – before later backing down”.

http://www.bbc.co.uk/news/uk-38101020

The choice of name is chilling – Omega being the last letter of the Greek alphabet, Alpha being the first. So the phrase ‘Alpha and Omega’ came to mean ‘the beginning and THE END’.

It appears that it has been resurrected.

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.

Corbyn finds his voice on NHS and Social Care

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!

London council threatens legal challenge over health service cuts

“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.”

http://localgovernmentlawyer.co.uk/index.php?option=com_content&view=article&id=29190%3Acouncil-threatens-legal-action-over-sustainability-and-transformation-plan&catid=174&Itemid=99