Beggars belief! Local Tories implicitly defend local bed cuts then put out a press release saying the total opposite!

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!

NHS underfunded? No, just wonderful say Tory MPs

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.

And now the UK Statistics Agency criticises NHS funding figures

“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.”

https://www.theguardian.com/society/2016/nov/23/government-scolded-by-watchdog-over-theresa-may-nhs-funding-claims?CMP=Share_iOSApp_Other

National Audit Office slams NHS ” transformation” plans

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/

Exmouth Regeneration Board has not discussed council overspend

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.”

About ….. turn! Councillors doing contortions?

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.

Save Clyst St Mary update – November 2016

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.

Proposed Sidford Industrial estate – flooding issues

Being planned on older flooding regulations because the application went in before they changed.

Today’s newspaper:

“The A375 between Sidford and Sidbury road is partially flooded and difficult driving conditions are reported on the A375 Sidbury Hill in both directions. Cotford and Woolbrook Road are also flooded.”

The Environment Agency is already in trouble for not spending money it was allocated for natural flood prevention schemes.

What about unnatural flood increase schemes?

If you had a child car seat that you bought a while ago that was declared unsafe for children under new regulations, would you continue to use it?

Why are developers allowed to ignore new regulations if their planning applications went in before changes which are designed to keep people and property safer?

UPDATE 5 pm: “The A375 is closed at Sidbury due to flooding and a landslip.”

http://www.exeterexpressandecho.co.uk/here-s-how-you-ll-get-home-tonight-in-exeter-mid-and-east-devon/story-29921797-detail/story.html

Save Exmouth Seafront meeting – 1 December 2016, 7.30 pm Harbour Cafe

see:

https://www.eastdevonalliance.org.uk/event/save-exmouth-seafront-ses-meeting/

and Exmouth Splash Facebook page

Devon worst hit by Storm Angus weather and floods – but little money for future prevention

“The government has been accused of being “all talk and no action” on flood defences, as the first named storm of the season brought flooding and power cuts to the south of England.

Storm Angus saw gusts of up to 106mph recorded 23 miles off the coast of Margate, while gusts of 80mph hit Langdon Bay, also in Kent.

While Met Office weather warnings connected with Storm Angus expired at 1pm on Sunday as the storm moved out to the North Sea, a new series of warnings were issued for Monday and Tuesday for heavy rain in south-west England, parts of northern England and Wales.

Andy Page, chief meteorologist at the Met Office, said Devon was likely to be most affected. “Although the more persistent rain should clear from Devon by early afternoon, heavy and possibly thundery showers are likely to follow,” he said.

UK government not funding natural flood prevention methods

“Around 20-30mm of rain is expected fall in a three- to six-hour period in places, with as much as 40-60mm possible locally through the whole of Monday. The ground has been left very wet from Saturday night’s rain and this increases the risk of further flooding.”

Page added that the band of rain affecting parts of southern England and Wales on Monday would extend to parts of northern England later on Monday and into Tuesday morning.

The warnings came as the government was accused of failing to deliver on promises to fund “natural” flood management schemes such as planting trees.

A freedom of information request by the environmental group Friends of the Earth to the Department for Environment, Food and Rural Affairs (Defra) revealed that there was no funding earmarked specifically for natural flood management, despite ministers saying they would fund such measures.

Natural flood management schemes aim to slow the movement of water downstream to prevent flooding. This can involve creating water storage such as ponds, planting trees along water courses and restoring rivers to their original meandering path.

In his budget in March, then-chancellor George Osborne announced an extra £700m for “innovative flood defence measures”. Friends of the Earth understands that former floods minister Rory Stewart earmarked £20m for natural flood defences before he left Defra in the June reshuffle.

In a recent letter to environmental charities, the environment secretary, Andrea Leadsom, wrote: “I fully support natural defence initiatives such as planting trees, which can slow the flow of water.”

Guy Shrubsole, climate campaigner for Friends of the Earth, said last winter’s floods “were a powerful reminder that we need to work with nature to reduce flood risk – and ministers wholeheartedly agreed”.

“So far it’s been all talk and no action,” he said. “The government has failed to spend a single extra penny on natural flood management.”

“Ministers must replace warm words with hard cash and announce a pot of at least £20m for natural flood defence in this year’s autumn statement. Anything less will be a betrayal of the communities that flooded so terribly last winter.”

A Defra spokesman said: “We’re committed to better protecting the country from flooding and natural flood management plays an important role in our strategy.

“We’re spending a record £2.5bn on flood defences to better protect 300,000 more homes by 2021 and many of these projects are already using natural flood management measures.”

The Environment Agency also issued nine flood warnings and 57 less serious flood alerts in the south-west and parts of the north of England.

Alison Baptiste, national flood duty manager at the Environment Agency, said teams had been working through the night and were now preparing for further flooding as rain continues over the next couple of days.

“People should remember not to drive through floodwater and be aware travel may be disrupted,” she said. “Environment Agency teams will clear blockages in rivers, continue to issue flood warnings and may operate flood gates and sea defences.”

https://www.theguardian.com/environment/2016/nov/21/government-criticised-for-lack-of-natural-flood-management-schemes?CMP=Share_iOSApp_Other

Daily Telegraph says street protests could reduce NHS bed losses

The Labour Party has a national day of action on Saturday 26 November 2016.
Devon has a county-wide non-political protest (“Draw a Red Line”) on Saturday 3 December midday Bedford Square, Exeter (see above for information)

Hospital closures planned to shore up NHS finances could be derailed if enough people take to the streets in protest, a health service chief has said.

Chris Hopson, leader of England’s hospitals sector, said public unrest and opposition by local MPs could scupper so-called Sustainability and Transformation Plans (STPs), which are billed as crucial to the long-term viability of the health service.

On Monday the respected think tank The King’s Fund heavily criticised health bosses for trying to organise the sweeping closure of hospitals and NHS units in secret, moves which it said could put lives at risk.

Yesterday Mr Hopson, Chief Executive of NHS Providers, said architects of the schemes were so far failing to engage local communities, which “have the ability to sink plans they don’t support”.

“It’s very difficult for the NHS to proceed with wholescale change if you’ve got people out on the streets marching with placards and banners and saying “don’t do this”,” he said.

“Fundamentally you can’t make big changes to service provision without taking local people with you.”

The plans follow an admission in May that the provider sector overspent by a historic £2.45 billion in the last financial year.

The country has been divided into 44 areas, with each ordered to come up with a proposal that both closes the gap and caters for booming patient demand.

So far the plans involve the closure of one of five major hospitals in South West London, an A&E unit in the North East of England, the loss of almost 600 beds in Devon and the possible closure of two A&E units in St Helens and West Lancashire.

Mr Hopson yesterday said unit closures were too widely being regarded as a “silver bullet” to make the “overambitious and undeliverable” plans conform to tight budgets.

“We have become obsessed by the money and not got the public engagement right,” he said.

“We are also trying to do it too quickly.”

But Sir Bruce Keogh, the NHS medical director, has this week there was “plenty of time” for the public to shape the changes.

External auditors not best placed to review Local Plan – Duh!

Honestly, you could not make it up. Independent councillors recently flagged that the NEXT review of the existing Local Plan needs to be sorted out NOW and not (as in the past) faffed-about with at the last minute.

So, some bright spark came up with the idea of asking EDDC’s FINANCIAL external auditor (KPMG) to get it going. Here is what happened next.

Problem (page 134 of agenda papers):
Undertake a Review of the process for writing the Local Plan in future”

The solution
“A meeting has been held with our external auditors to scope out this review but it was quickly determined that they are not the right people to undertake this review due to their lack of knowledge of the plan making process. Other options including using the Planning Advisory Service (PAS) are now being pursued.”

Click to access 241116-scrutiny-agenda-combined.pdf

Duh, duh and more duh!

NHS cuts on EDDC scrutiny agenda – 24 November 2016, 6 pm

The full consultation document begins on page 9:

Click to access 241116-scrutiny-agenda-combined.pdf

English devolution: 4 deficits and “unelected dictatorship”

In an article on the London School of Economics website by Bob Hudson, a Professor in the Centre for Public Policy and Health, University of Durham, he argues that the current process has four major deficits and goes i to detail about each one. The four are:

Democratic Deficit
Constitutional Deficit
Financial Deficit
Strategic Deficit

An interesting comment on the article from Malcolm Bell reads:

The whole trend in contemporary government is to suppress democracy and impose control by unelected elites. The principle is established in the EU where the commission trumps the elected Parliament. Devolution to the regions is intended to develop this theme. The British government is rapidly changing to decision-making in the increasingly remote “executive” as the House loses control. It used to be said that we had an elected dictatorship, that is rapidly being replaced by an unelected dictatorship of the elite. Accountability is almost entirely a thing of the past, this is not accidental but deliberate policy.”

So much for sovereignty of Parliament!

The REAL-LIFE Devon NHS cuts

“The proximity of North Devon district hospital to Anne-Marie Wiles’ home – it is less than five minutes away – is crucial.

Her twin sons, Jed and Peirce, were given just six months to live after being born with multiple complex health needs. They are now doing well, aged 16, thanks in large part to the efforts of a loving family, but also the dedicated staff at the hospital in Barnstaple.

“I intentionally live opposite the hospital because when the boys stop breathing there is not enough time to call an ambulance,” said Wiles. Jed has been resuscitated three times at the NDDH and both have been nursed countless times at the Caroline Thorpe children’s ward.

“If these services end then my boys will for certain die once they become ill,” said Wiles. “I am fearful of losing my children.”

She is one of thousands who have joined marches, written to local MPs, organised benefit gigs, signed petitions over the Wider Devon STP – sustainability and transformation plan – which is proposing radical changes to healthcare in the county.

If the plan comes to fruition in its present form, 600 community and acute beds across this sprawling, largely rural county will be gone within five years.

Cherished community hospitals at Honiton in the east – nicknamed the Honiton Hilton because it so beloved – Okehampton in central Devon and Paignton and Dartmouth in the south would go. There have been howls of protest everywhere – but nowhere more than in and around Barnstaple.

Here there is deep alarm that the plan may lead to the shutting down of maternity, neonatology and paediatric services as well as triggering the loss of other departments, including A&E. The Royal Devon and Exeter hospital is 50 miles away – an hour and 10 minutes by car down a winding road if conditions are good, much more if not.

Tina Day’s son, Jaiden-Lee, was born at the NDDH with a collapsed lung and spent a week in the special care baby unit for a week before developing type 1 diabetes. “It terrifies me if services like maternity and A&E are re-located. People will die, guaranteed,” said Day.

John Tate claimed his wife and daughter would both have died had the NDDH not been near. “My daughter had her umbilical cord wrapped around her neck. She had breathing problems and was trapped head down. This caused my wife life-threatening problems. An emergency cesarean saved their lives. Both would have died if Barnstaple was not there.”

Crystal Steinberg said the closure of the maternity department would make her think twice about having a second child. She underwent an emergency caesarean section because her unborn baby, Dylan, was in distress. “I do not want to be stranded at the side of the road while my uterus ruptures and my baby and I die.”

It is not just mums who are worried. Tracy, 46, suffers from a mental health condition that leaves her suicidal. “I have been to A&E three times this month after being picked up by police.” Should the A&E close she believes she would be held in a cell or have to head to Exeter. “I’d have no way of getting there but to walk or hitch. Both are a scary.”

Jacob Egan, seven, was so concerned when he got wind of the proposals that he dictated a letter to Theresa May. He has brittle asthma, which can result in severe attacks, and has been admitted to the NDDH around 10 times.

“Dear prime minister,” he said. “Just think about it, every time any child in our area of north Devon needed to go to hospital they would have to go to Exeter. Exeter is a long distance away and if your heartbeat stopped you couldn’t just wait for a train or car to get you there.”

At the heart of the plan is a “new model of integrated care” that will “reduce reliance on bed-based care and enable people to live healthy independent lives for longer, closer to where they live”. In other words the idea is to look after people at home rather than in hospital.

According to the latest draft of the report, which is up for consultation, every day more than 600 people in Devon are medically fit to leave hospital beds but do not.

The plans argues change must take place. Health and social care services in Devon are likely to be £557m in deficit in 2020/21 if nothing is done, the plan says. It also says the system as it stands isn’t working. The 95% standard for patients being seen in A&E within four hours is not being met – the Devon system is currently achieving 91.6%.

Devon’s demographics also have to be taken into account. There are more elderly people here than in other parts of the UK – in one area of Torquay almost one in 10 are aged over 85. Some need a lot of care – in north, east and west Devon, 40% of people use almost 80% of health and social care.

Angela Pedder, lead chief executive for the plan, said she understood people’s concerns. “But if we sit back and say let’s just let things happen, that’s a much bigger risk not just for the whole of Devon.

“We have to be pro-active. We have responsibilities to make sure the service is safe and sustainable two, five, 10 years down the line. That’s what we’ve got to plan for. That’s the framework we are trying to put in place.”

Politicians, activists and patients are not impressed.

The East Devon Tory MP Hugo Swire said: “We are in danger of putting the cart before the horse. Until we can absolutely ensure that we have got social care right, we should not look at unnecessarily closing community beds.”

Jan Goffey, the mayor of Okehampton, called the proposals cruel and claimed the NHS was being “dismembered”. If the people who actually live in Barnstaple are worried, those that live even further north – and so even further from Exeter – are even more concerned.

Sarah Vander, who runs a shop in the cliff-top village of Lynton, 20 miles north-east of Barnstaple, said her mother had been saved from a stroke and her husband from a diabetic hypo – a drop in blood glucose level – because they got to the NDDH quickly. “We are incredibly remote and we must be able to rely on the excellent services of NDDH otherwise the simple fact is, people will die unnecessarily.”

The seaside town of Ilfracombe, 12 miles north of Barnstaple, suffers a double whammy. The town is isolated and some areas are deprived: life expectancy in central Ilfracombe is 75 compared with 90 in parts of east Devon.

Rebecca McGarry, from Ilfracombe, the mother of daughters aged two and three, said she felt sick thinking about the prospect of losing services. Both her children have received excellent treatment in Barnstaple including for severe croup, which makes it difficult for them to breathe.

McGarry’s husband is a carer and needs the car for work so she often has to take her children to the hospital on the bus. “I honestly don’t know how we would manage if these appointments were moved even further away. The idea that such a remote region should lose these vital services is totally absurd. People will lose their lives if these closures do happen.”

https://www.theguardian.com/society/2016/nov/18/nhs-cuts-in-devon-if-these-services-end-my-boys-will-for-certain-die

Is a cost over-run of £1.1 million or £10 million more serious than a Section 106 loss of £250,000?

Owl asks because an elector successfully petitioned EDDC’s external auditor over Section 106 discrepancies. A sample found a wrongly-attributed bill of some £400,000 and an uncollected sum of around £250,000. As a result, the auditors have requested many changes in procedures:

Click to access item-12-management-of-s106-contributions-report.pdf

Now we hear at Cabinet this week that, in two years, development costs for Exmouth seafront have risen from £1.5 million to £3.2 million. Yet Cabinet apparently found this totally acceptable and, without detailed figures, nodded it through with no explanation of:

– what did the £1.5 million cover

and

– what does the extra £1.6 million cover.

Added to this, the projected cost of HQ relocation has risen from cost-neutral (zero due to sale of Knowle HQ for around £7 million) it is now said to be nearly £10 million – or at least that was figure a few months ago.

These are eye-watering numbers yet majority party councillors and auditors (internal and external) appear unconcerned.

Some scrutiny (internal and external) needed here, Owl thinks.

Exmouth seafront cost increase – fantasy, incompetent, iconic or ironic!

“Calls have been made for the sacking of the ‘owner’ of the Exmouth Seafront Regeneration Project after costs spiralled from £1.5million to more than £3million.

However, East Devon District Council’s (EDDC) cabinet backed the plans with a majority vote, despite heavy criticism from some councillors.

http://www.exmouthjournal.co.uk/news/seafront_plans_backed_despite_soaring_costs_1_4780508

Rob Longhurst (Ind), Ben Ingham (Ind) and Eileen Wragg (LD) spoke against, saying that it was incompetence.

Ian Chubb said it was worth paying and he was happy paying the extra costs. Unclear whether he meant worth paying despite the increases or worth paying despite the incompetence, but nice of him to offer to fund the increased costs personally.

Phil Twiss said they had to proceed because to stop would be to go backwards. Of course only true because they have destroyed existing attractions before getting the plans right and before knowing the real costs – so they can’t go back.

Philip Skinner got his words mixed up when he said the plans were iconic but clearly he meant ironic, and thought it was good for Exmouth because they all like doing watersports.

Tom Wright obviously thought the debate was about football not water-sports because he kept referring to the premier league, and said that Exmouth residents should be grateful for the cost increases.

Honestly, Trump or EDDC Tories – not sure which are the greater fantasists!!”

Poor commercial judgement and skills at local authorities worrying

Hot on the heels of news that EDDC’s development costs for Exmouth seafront have more than doubled from £1.5m to £3.2m comes this report:

The increasing scale of commercial activity carried out by local authorities could put council finances at risk, and town halls might lack the necessary skills for such projects, the Public Accounts Committee has warned.

In a report examining the financial sustainability of local government, published today, MPs accused Whitehall of being complacent about the risk to local authority finances.

Today’s “Financial sustainability of local authorities” review highlighted that councils were increasingly undertaking commercial activity intended to generate revenue income from capital investment in properties and businesses in an effort to offset government cuts. This includes projects such as developing houses and commercial units for rent or sale.

But the MPs warned councils may lack experience of such schemes, and council tax bills or other services could be hit if they go wrong. They called on the Department for Communities & Local Government to review the commercial skills in different types of authorities, and provide an update by next summer on the scale and nature of these activities in order to better anticipate risks.

We do not share the department’s confidence that the increased commercial activity in the sector adds no particular risk to the department’s own work,” the report stated. The department should also work with CIPFA to ensure the local government capital finance framework “remains current and continues to reflect developments”.

Committee chair Meg Hillier said funding cuts had led councils to rethink the way they use public money, and the government wanted councils to become largely self-financing, including through business rates retention. However, she warned that poor investment decisions could cost money that might otherwise be spent on public services.

“Our committee has previously highlighted gaps in the commercial skills of the civil service as a factor in the failure of some projects and we have similar concerns about local government,” she stated.

“Local authorities need the skill-set to invest wisely and the department must bear its share of responsibility for ensuring these skills are in place. But more fundamentally, the information central government uses is inadequate for understanding trends and associated risks in local government finance.”

This represented a serious flaw in DCLG’s ability to plan properly for the future and ensure councils are following a sustainable path, she concluded, but the department was complacent about the risk. …

“Promised £8bn extra for NHS is not enough, says hospitals boss”

Theresa May will have to rip up the government’s financial plans for the NHS and commit more than the promised £8bn extra by 2020, a hospitals boss has said.

Chris Hopson, the chief executive of NHS Providers, said ministers must come up with a new plan to fix the health service’s crumbling finances or risk it becoming unable to function properly.

In a submission to the Treasury before next week’s autumn statement, NHS Providers, which represents 96% of NHS trusts in England, says a rethink is necessary because the calculations underlying the government’s £8bn pledge are flawed.

It says demand for care is rising faster than envisaged in the blueprint drawn up by NHS bosses in 2014, the Five-Year Forward View, and social care has deteriorated.

Hopson said: “Some of the key assumptions in the Five-Year Forward View, on which the current financial and NHS delivery plans for this parliament are based, have turned out to be wrong. There is now a clear and widening gap between what is being asked of the NHS and the funding available to deliver it.

“The NHS simply cannot do all that it is currently doing and is being asked to do in future on these funding levels.”

Andrew Lansley, the health secretary from 2010 to 2012 in the coalition government, recently said the NHS needed a “Brexit bonus” of £5bn on top of the £8bn already pledged, given the widespread public demand for higher NHS funding revealed by the EU referendum.

NHS Providers does not specify how much more it wants invested. But Hopson said more than £8bn was justified because “demand for care is a lot higher, social care is in a much worse state, general practice is turning out to be more unstable, and the starting point for the deficit among hospital, mental health, community and ambulance trusts has turned out to be much larger.”

He said the overall health budget would go up by only £4.5bn by 2020, not the £8bn ministers pledged last year, because money was being taken from key areas such as public health in order to give the NHS its promised increase. Independent experts agree £4.5bn is the true increase that healthcare will get.

The NHS’s inability to deliver the £22bn of savings it had promised to make by 2020 – a target that had always been “too ambitious” – further underlined the need for more money to be found before the end of this parliament, said Hopson.

May has been under pressure recently over her repeated claims that the government is giving the NHS £10bn more, and more than the NHS England chief executive, Simon Stevens, asked for in 2014. Sarah Wollaston, the Conservative chair of the Commons health select committee, and other members of the committee wrote to the chancellor Philip Hammond to say the claims were untrue. Labour has asked the UK Statistics Authority to rule on whether the £10bn claim is justified.

Jeremy Hunt, the health secretary, has subtly distanced himself from the £10bn figure and said the NHS will need a lot more money after 2020, at the end of its unprecedented decade-long budget squeeze.

Ministers have already told Stevens that the NHS will not receive a funding boost in the autumn statement. But NHS and local council leaders hope the chancellor may find some extra money to prop up the ailing social care system.

“NHS funding increases from next year onwards are not enough to maintain standards of care, meet rising demand from patients and deliver essential changes to services,” said Richard Murray, director of policy at the King’s Fund thinktank.

“If additional [NHS] funding is not forthcoming later in the parliament, the government will need to be honest with the public about the impact on quality of care and access to services.”

The Department of Health did not respond directly to Hopson’s comments. A spokesman said: “This government has taken tough economic decisions that have allowed us to invest in our NHS, which is meeting record patient demand whilst improving standards of care. We have prioritised funding for the NHS with £4bn extra this year.”

https://www.theguardian.com/society/2016/nov/17/promised-8bn-extra-for-nhs-is-not-enough-says-hospitals-boss

Franksy writes to East Devon Watch

See below the letter Franksy asked a correspondent to send to East Devon Watch:

To Tyrannosaurus Exe, also known as EDDC,

I marched with 386 others on Saturday to try and save Exmouth Seafront.

Did you not see us because your head is so high in the clouds filled with your own obstinate dreams of power?

Did you not hear us because you can only hear the sound of your own species? Maybe you cannot hear at all.

With your big and brutish attitude and your enormous footprint, you can barely see the ants you look down upon.

But ants are strong and resilient. They work hard, communicate and co-operate to achieve a common goal.

Important to note that ants are not extinct.

We hope this troubles you in your arrogance.”

Franksy.