Health and Adult Care Scrutiny Committee, County Hall, 25 January 2018

“I take my Scrutiny duty very seriously,” declared Cllr Brian Greenslade (Barnstaple North) at the Devon County Council Health and Adult Care Scrutiny Committee meeting at County Hall on 25 January. Save our Hospital Services (SOHS) members from North Devon who attended this and many other such meetings know this to be only too true.

Indeed, were it not for Cllr Greenslade and his meticulous colleague, Cllr Claire Wright (Otter Valley) it is doubtful how much scrutiny by the Scrutiny Committee there would be at all. One thing is certain: given the scale, speed and scope of the changes now being pushed through in health and social care services in Devon, real information, real questions and real answers have never been so vital. It is literally a matter of life and death.

At a previous Scrutiny meeting, the Chair, Cllr Sara Randall Johnson, in clear cahoots with Cllr Rufus Gilbert, manipulated proceedings. The two managed to prevent Cllr Wright putting a motion she had already tabled, thus shutting down a debate that may have saved in-patient services at some community hospitals.

This so outraged some councillors and members of the public that their chorus of complaints and the consequent internal investigation prompted the county’s lawyers to lecture councillors as to their legal obligations to scrutinise. The investigation and warning came too late for the community hospitals, but could better behaviour be expected from now on?

Indeed, it could. But then, on 25 January, the Chair of the Standards Committee was sitting in. This time Cllr Wright was allowed to say quite a lot, pose many more questions, and state much more of the obvious in defence of our health and social care services.

However, far too many of our County Councillors still appear unwilling to spend time and effort educating themselves as to the issues, facts and figures, whilst being only too willing to swallow propaganda and projections put out by overpaid health bosses bent on making severe cuts to our NHS services.

No one, even councillors who have barely raised a whisper in opposition, is in any doubt as to the real motive for all these health service changes: cuts and cutbacks designed to save £557 million over the next five years. The aim is to ration, restrict and remove elements of care and treatment for however many people it takes to save that amount of money. Cost comes first, clinical need a poor second.

Dr Sonja Manton was again allowed to speak at great length. She is NHS Devon’s lead cost-cutter, qualified by means of a doctorate in Systems Dynamics, not qualified in Medicine or any form of clinical care. Which sort of gives the game away –as does her most obvious skill, talking for a very long time without saying anything at all.

When questioned by Councillor Wright, she appeared, as ever, not to have the required data or evidence to hand. Cue the now customary promise to look it up and pass it on. The pattern that follows has been obvious for more than 15 months now. The Scrutiny Committee ends up waiting a long time for what they have asked for – if they get it at all — making real scrutiny in public for the public impossible. The lack of real information, the failure to meet requests, the failure to resolve contradictions in presentations cause real difficulties for our County Councillors meeting after meeting – not least again on 25 January.

It has been reported that Devon’s Clinical Commissioning Groups are bent on steamrollering ‘Accountable Care Organisations’ into position from 1 April. To prove that the joke is on us for what is, after all, April Fool’s Day, they have given the Scrutiny Committee no information about them at all. This is particularly scandalous and frightening. As Brian Greenslade stated: “I want to know where we are…..we need to understand where we’ve got to and what this may mean.”

One faint beacon of light is the announcement, on the same day as the Scrutiny meeting was held, that NHS England will hold 12 week consultations on the implementation of ACOs https://www.england.nhs.uk/…/consultation-aco-contracts/ which puts a very slight delay in place. But the website does not elaborate on how much time after closure of consultation implementation could happen. The Consultation could well be the outcome of an exchange between Sarah Wollaston, Chair of the Health Select Committee, and Jeremy Hunt, Secretary of State for Health and Social Care, as well as an attempt to water down the possible impact of a Judicial Review, which is being filed by a group of Health Care professionals, to challenge the government’s attempt to circumvent Parliament and democratic scrutiny and allow ACOs to operate

ACOs are financially constrained, business-based American-style systems of healthcare purchasing and provision, which will pave the way for further privatisation and still more rationing and restriction of provision. Councillor Martin Shaw from Seaton had done a lot of research on ACOs and put his findings online. But, incredibly, he had to force the whole issue onto the Committee’s Agenda just to secure the very limited discussion that took place.

Until this announcement it was the case that ACOs (unless the Judicial Review has effect) were to be imposed without any debate, discussion or statute. So an ACO could be and, in many cases, will be, a private business, primarily accountable to shareholders and managers rather than patients and the public. And even now we don’t know how ‘public’ the consultation will be. As Jan Goffey, Mayor of Okehampton, declared, “Sick people should never be regarded as a profit-making opportunity.”

Eventually even the Chair, Sara Randall Johnson said, “We need more information.” We have heard her, and others, say this before. Is this a way of avoiding doing anything? Or is it something more cynical: a way of helping to destroy our NHS, but giving themselves the excuse that they just did not know?