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20 Sep 2016

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DCC, East Devon Tories, Health and Social Care (local), NHS (local)

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RIP Devon NHS – Conservatives get special advance briefing

“A ‘confidential’ briefing to Conservatives on Devon County Council confirms community hospital beds across the county will be cut and patients will not be admitted for treatment and care ‘unless it is absolutely necessary’.

The NHS has planned a series of carefully orchestrated announcements tomorrow (Wednesday 21st) but it has now been revealed that Devon’s Conservative councillors had a confidential email last week telling them about some of the planned cuts.

It’s angered other councillors who are demanding to know why confidential information was given to the Conservatives on Thursday last week (15th).

Cllr Alan Connett, Shadow leader of Devon County Council and leader of the Liberal Democrat opposition, said: “The NHS belongs to everyone. We are all concerned about what the new plans will mean and how treatment will be affected for residents.

“Yet again, we find the Conservatives at County Hall think the rules don’t apply to them. Isn’t it hugely arrogant of them to slip out a secret briefing in the early hours of Thursday to their own councillors a full week before NHS managers announce their plans publicly.

“It’s another Conservative shambles and will greatly undermine any confidence we can have in them or the NHS which, presumably has been telling county hall chiefs what’s in the cuts pipeline.

Across Devon, people may well be wondering if some grubby private deal has been stitched up between NHS bosses and county hall Conservatives over these planned cuts.”

In a confidential email to just Tory councillors, Conservative Stuart Barker, cabinet member at county hall for health and adult social care, said: “There are some consultation documents going out from the NHS which are likely to have an effect on the budget for adult social care.

“I am sending you a synopsis of some things that are in the consultation documents and included some information about how DCC (Devon County Council) could be impacted.

“We shall be working with NHS partners to ensure DCC has a share of any savings that can be found.”

And Cllr Barker goes on to tell his Tory colleagues: ” The NHS believe that there are too many people in community hospital beds across Devon, who don’t need to be there.

“Every day, in NEW Devon, there are 150 people in community hospital beds that could be cared for at home. In addition, of the current 247 community inpatient beds across the NEW Devon CCG (clinical commissioning group) footprint approximately 100 beds are unused.

Cllr Connett added: “We can see what’s planned, can’t we? The NHS is reported as saying they don’t need the 150 beds now being used and, by strange co-incidence, there are 100 beds not being used at all. Magically, the two come to around 250 – the same number of community hospital beds the NHS want to close.

“I’m as keen as everyone else to hear what the NHS plans are for health cuts across Devon, but I think it is totally wrong for the Conservatives to sneak out a private briefing just for their councillors, which will undermine the whole public consultation process the NHS is about to launch.”

http://www.theprsd.co.uk/2016/09/20/confidential-briefing-confirms-nhs-community-hospital-beds-close/

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East Devon Watch

Posted on

20 Sep 2016

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Health and Social Care (local), Housing (local), Inequality

Report: “Getting ready for ageing”

“… Stop seeing ageing as being about older people: Ageing is about all of us. It isn’t about young versus old. We will fail to tackle the challenges and make the most of the opportunities of ageing whilst we pitch one generation against another.

Stop ignoring the demands and needs of an ageing population: In Government there is not and never has been a Minister, senior social or other post holder such as a ‘Commissioner’ or ‘Tsar’, or any cross cutting unit or Government strategy on an ageing society.

Stop delivering communities which fail to deliver beyond the basics: Sadly, many communities are even failing to provide the basics of public toilets and places to rest. A fear of falling and of crime acts as a barrier to getting out and about for many older people. We must deliver a more ambitious vision for our communities: of places which are fun and engaging for all ages, whilst also reducing the risk of isolation and loneliness.

End the discrimination: Age discrimination remains a barrier to the participation of older people in society. Legislation has gone some way to prevent discrimination but policymakers must ensure that older people are not prevented from accessing products and services simply because of their age. We all need to play a part in normalising ageing.

Reverse the decline in new and appropriate housing stock for older people: The numbers of new retirement homes being built are being allowed to fall at the same time as the numbers of older people are rapidly increasing. Too few new homes are being built. Those which are, are too often not accessible or adaptable for old age.

Stop ignoring the crisis in social care: Government investment in social care is sharply shrinking while the numbers of older people who need it are rising, yet good social care saves public money by reducing and postponing older people’s need for expensive acute hospital care and helps them to live independently for longer. Good social care for older people also allows family members to keep in employment – so they are not forced to choose between work and caring for an older relative.

Stop operating hospitals on a model designed for the past: Hospitals of the 21st Century are increasingly made up of older patients with complex needs. Sta ratios on hospital wards dedicated to older people, many of them with dementia, are typically lower than those in general wards. Yet we know that these older people often have greater need of help with essentials like eating and drinking.

Stop under-utilising older people: The over 65s in the UK currently spend around £2.2 billion per week (£114 billion per annum) on goods and services. Assuming the spending of the 65+ population rises in line with annual in ation of 2%, their spending will reach over £6 billion per week by 20377. People aged 65 and over in the UK last year contributed £61bn to the economy through employment, informal caring and volunteering. Yet almost four in ten workers aged 55-64 are not working. And almost half of the unemployed of this age range are in long term unemployment. We must do more to maximise the social and economic contribution of older people.” …

http://www.cpa.org.uk/cpa/docs/Ready_for_Ageing_Alliance_Manifesto.pdf

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East Devon Watch

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16 Sep 2016

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Accountability, Claire Wright, DCC, Health and Social Care (local), Hugo Swire, Neil Parish

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“Devon’s ‘devastating’ hospital cuts to be scrutinised”

We await Hugo Swire and Neil Parish’s plans on how to deal with devastating health and social services cuts in Devon. In the meantime, DCC councillor Claire Wright continues her long and tireless campaign on behalf of East Devon residents.

“Plans to cut nearly 200 community hospital beds across Devon by 2020/21 will come under the scrutiny of county council health bosses on Monday (September 19).

Councillor Claire Wright (pictured) described the proposals in a leaked document as ‘devastating’ and said the underfunding of the NHS should not mean that patients suffer.

More than 400 acute hospital beds in the county – one in six – could close, as the NHS in Devon looks to plug a predicted funding gap of £572million by 2020/21.

The leaked Sustainability and Transformation Plan (STP) for Wider Devon states: “The changes we are proposing will result in a reduction in the number of acute and community beds across our system of the order of 590 by 2021.

“NEW Devon Clinical Commissioning Group (CCG) are developing consultation proposals on the overall strategic direction of travel and provision changes, the components of new models of care and specific intentions to close a number of community hospital beds.”

NHS bosses were approached for comment, but would not specify how the cuts would affect different localities.

Cllr Wright said: “My understanding is that the document was submitted to NHS England for its consideration in June.

“That’s three months ago – why on earth it has been kept so secret from residents, and councillors including those like me on the health and wellbeing scrutiny committee?

“As an Ottery St Mary councillor, I am very worried indeed now for Ottery Hospital’s future – and the impact that so many acute and community bed closures in general will have on patient care all over the county.

“The fact that the NHS is massively underfunded should not mean that patients have to suffer.”

A statement issued by NEW Devon CCG says more analysis and consideration was to be undertaken before a further submission is made in October.

It said: “The STP creates the opportunity for health and local authorities to work together and formulate plans to improve and secure the sustainability of services we deliver to people across Devon.

“The programme of work to review acute and specialised service across Devon will commence in October.”

A report on the STP will be given to Devon County Council’s health and wellbeing scrutiny committee on Monday.

http://www.sidmouthherald.co.uk/news/devon_s_devastating_hospital_cuts_to_be_scrutinised_1_4698027

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East Devon Watch

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2 Sep 2016

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Health and Social Care (local), Planning System

“Make health material consideration in planning and licensing law: MPs”

“The Government must make good on its commitment to health in all policies by enshrining health as a material consideration in planning and licensing law, MPs have said.

In a report on Public health post-2013, the Health Committee said it had heard evidence that this would help local government to directly improve the health of their local communities and reduce health inequalities.
“Local authorities need the levers to be able to take effective action to protect local communities and this is especially important given the cuts to their budgets,” the MPs added.

The report noted how local authorities had been dealt an in-year cut of £200m last year and now faced further real terms cuts to public health budgets.

But the MPs warned that cuts to public health and the front line services they delivered were a false economy “as they not only add to the future costs of health and social care but risk widening health inequalities”.
The committee highlighted Theresa May’s comments in her first speech as Prime Minister, where she put a reduction of health inequalities at the top of her list for action.

The committee called on the Government to recognise that tackling health inequalities and improving public health would not primarily happen in hospitals, even though hospitals received the lion’s share of health funding. “Rather, it requires a whole life course approach, tackling the wider determinants of health in local communities, effective action on prevention and early intervention, and through joined-up policy making at a national level.”

The MPs also claimed there was a “growing mismatch” between spending on public health and the significance attached to prevention in the NHS 5 Year Forward View.

The report called for a Cabinet Office minister to be given specific responsibility for embedding health across all areas of Government policy at national level.

It concluded that while there was evidence of progress locally, there was less evidence of such an approach becoming embedded across Government departments.

Health Committee Chair, Dr Sarah Wollaston MP, said: “The disappointing watering down of the childhood obesity strategy, published in August, demonstrates the gap in joined-up evidence-based policy to improve health and wellbeing. Government must match the rhetoric on reducing health inequality with a resolve to take on big industry interests and will need to be prepared to go further if it is serious about achieving its stated aims.”

http://localgovernmentlawyer.co.uk/index.php?option=com_content&view=article&id=28225%3Amake-health-material-consideration-in-planning-and-licensing-law-mps&catid=174&Itemid=99

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East Devon Watch

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30 Aug 2016

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Health and Social Care (local), Sidmouth/ Sidford/ Sidbury

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NHS Property Services stitches up Dr Sytch’s Sidmouth surgery

“Plans to completely redevelop Sidmouth’s Blackmore Health Centre – adding new flats and a pharmacy – have left GPs fearing for its future.

Sid Valley Practice partners have been denied the chance to buy their town-centre building – taken over in 2013 – and say owner NHS Property Services (NHSPS) seems to be on a ‘commercial drive’ to squeeze profit from the site.

GPs say they are struggling to work in the rapidly deteriorating premises – branded ‘non-fit for purpose’ by the Care Quality Commission in July 2015. They have spoken of concerns that current proposals do not future-proof the site or leave any room to expand as the population grows.

The GPs remain ‘absolutely committed’ to retaining the town-centre surgery and are appealing for support from the community.

Doctors say the company responsible for managing NHS property has hiked up charges to the practice by around 50 per cent, despite so far failing to make the six-figure investment needed in the building.

An NHSPS spokesperson said the company is ‘committed to delivering improvements’ and recognises the concerns raised by GPs.

Dr Joe Stych, one of the practice partners, told the Herald: “The plan at the moment includes 10 residential flats on the squashed site. The implications of this will be quite large.

“A concern is that if the site is developed into flats and sold off, this facility would lose future expansion space available to the NHS as the town grows. Practice partners have been desperately trying to buy the building to protect it long-term, but have been turned down. Since NHSPS took ownership, costs passed on to the NHS and GPs for running this facility have increased to a level it may not be financially viable for the surgery to continue to practice there long-term.

“One of the big concerns for us is future-proofing the practice. The plans that are there do not future-proof the practice for the town in the short-term, let alone the long-term. “

The practice partners personally shouldered a £2.1million loan to build the new Beacon Medical Centre off Stowford Rise – and say they are ‘absolutely committed’ to retaining a town-centre surgery.

Dr Stych added that doctors do not feel their concerns are being listened to, so they have resorted to appealing for public support in efforts to safeguard the future of the Blackmore Drive surgery.

Chairman of the Sid Valley Patient Participation Group, Di Fuller, called for the community to get behind a campaign to save their surgery. She says the NHSPS is making it increasingly difficult for the practice, adding: “From a patient perspective, we already know there is a lot of anxiety in the town about the security of the Blackmore Surgery. Our anxiety is that, once it’s redeveloped, it will be great, but the rent they will demand will possibly make it unsustainable.

“At the moment, I understand that they are not planning to make the accommodation large enough for expansion, which is really cause for concern. They are trying to maximise profit and income from the property.

“We are a patient group that works hard to bridge the gap on behalf of patients, but we need the community to get behind us on this.”

East Devon’s MP Hugo Swire agreed it would it be ‘wholly inappropriate’ for people in Sidmouth to experience a reduction in healthcare provision. He said he will seek a meeting with relevant parties to discuss the future of Blackmore Health Centre.

A spokesperson for NHSPS said: “We are committed to delivering improvements to this surgery, including draft proposals for a scheme which could provide homes and a brand new surgery on the site.

“The GPs raised concerns about the car parking and we have revised the proposal, but discussions are continuing on this, or the option to refurbish.

“We clearly want to ensure the best possible outcome for the practice and local patients. We are listening to the GPs and fully recognise their concerns. We will continue to work with them to address these, including queries about their billing.”

http://www.sidmouthherald.co.uk/news/sid_valley_doctors_issue_sos_save_our_surgery_1_4671922

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East Devon Watch

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28 Jun 2016

Posted under

Accountability, Democracy, Health and Social Care (local), Inequality, Post-Brexit Adjustments

Oliver Letwin (2) – privatise, privatise, privatise – including the NHS

The man David Cameron just put in charge of the government’s Brexit policy (see post directly below)

Oliver Letwin books andpamphlet:

Oliver Letwin and John Redwood. (1988)

Britain’s Biggest Enterprise – ideas for radical reform of the NHS

“… four out of five main recommendations made in the 20-page pamphlet are already being put into place.

Britain’s Biggest Enterprise :

– calls the NHS “a bureaucratic monster that cannot be tamed”.
– says the NHS needs “radical reform” and “revolutionary ideas”.
– claims waiting lists were caused by the “system itself” rather than a lack of funds, and that spending more money would simply increase waiting lists.

It makes these five recommendations:
1) Establishment of the NHS as an independent trust.
2) Increased use of joint ventures between the NHS and private sector
3) Extending the principle of charging

Source: http://liberalconspiracy.org/2011/06/03/revealed-the-pamphlet-underpinning-tory-plans-to-privatise-the-nhs/

Oliver Letwin (1988)

Privatising the World: A Study of International Privatisation in Theory and Practice

Amazon Books 1 star Review:

This is the well spring of what they are doing to our country. The owners of the snouts in the trough that cannot bear to think of any money, any transaction happening without a profit being made for a shareholder or a bank, or Letwin’s friends like Cameron, Osborne and Hunt. An appalling treatise on how greed is right and the public interest is wrong. How to dismantle the stuff that glues us together and sell it off to corporate cartels – the failure of the fuel market, the chaos of our “privatised” railways, the reluctance of bus companies to run unprofitable routes, zero hours contracts – all of these should be warnings of where this sort of poisoned, anti social thinking can lead. Read this book and be afraid.

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East Devon Watch

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17 Jun 2016

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Accountability, Budleigh Salterton, Health and Social Care (local), Transparency

Budleigh Hospital – the, somewhat hazy, future?

These are notes written by an attendee at the recent meeting about the future of Budleigh Hospital. It represents the attendee’s personal views.

The way in which ” rent” is being tackled is very novel but, as always, the devil is in the detail.

Owl hopes the League of Friends has access to good lawyers!

“Budleigh Hospital League of Friends AGM followed by Wellbeing Hub Q&A 16/06/16

Chair’s perspective

• According to Chair, Dr David Evans, Swire and Toby Williams have been ‘very helpful in ironing out problems’ – more info on this would be interesting – eg what has Swire actually done (probably just enabling the roll out of Tory ideological destruction of the NHS at a local level?!).

• Dr David Evans also reported that he thinks the wellbeing hub is a pioneering project, one that he believes will be a model of success that other community hospitals in Devon will want to follow. There was a confusing and bizarre message that we should be proud of what we have (an empty building?!). Perhaps he was referring to the work of the League of Friends who do seem to put a lot of work into something that must be very incredibly frustrating.

NHS Property Services

• A contract will be signed between the League of Friends and the RD&E FT that will allow the Wellbeing Hub to ‘overcome’ the commercial rent issue for charitable organisations.

• The League of Friends described this lease as a ‘compromise’. In practice all rent will still be commercial (as they kept saying, this is ‘a legal requirement’), however as the League of Friends has money (raised locally) that they want to invest into the building, they have agreed (verbally at this point), that the money invested by the League of Friends will be converted into a lease – so a £100,000 investment in the property will be translated into a reduction (% unclear) for charitable sector users.

Sustainability, administration, etc all unclear, my question was about clarifying what was initially just a mention of this lease/compromise, but the answer didn’t go far enough.

• However a local alternative therapies practitioner (eg I know of one who wanted to rent space) would probably be charged commercial rent and therefore unlikely to be feasible for them to work from/offer services from the wellbeing hub.

The wellbeing hub

• In September they hope to have some example services available. But then this was contradicted with no access to building until 2017.

• Building is still in reasonable condition and a report of the work done while closed has been issued to the League of Friends (cost of work maintaining the empty building could be an interesting FOI as the League of Friends did not specify).

• It was suggested that the closure has allowed time to consider and test what ideas will work for the hub. Not convinced by this logic – I am pretty sure the hospital demonstrated that.”

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East Devon Watch

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13 Jun 2016

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Claire Wright, Health and Social Care (local), Hugo Swire, Ottery St Mary

Claire Wright responds to Hugo Swire’s rant about independents and the “Ottery Pack”

From Claire Wright’s Facebook Page

It was fortunate for Mr Swire that I was in the process of moving house and without internet for two weeks which meant I couldn’t respond fully to his blog posts that I fundamentally take issue with, relating mainly to Ottery St Mary Hospital and his government’s property management company, which is set to acquire 12 community hospitals in Eastern Devon, later this year.

Fortunately, I now have a full internet connection and below is my reaction.

Mr Swire seems angry that around 250 people came along to my demonstration at Ottery Hospital last month and didn’t believe his claims that the Secretary of State’s for Health’s new private company – NHS Property Services is entirely well meaning and benign.

Residents present were sceptical of his assertions that the company is only acquiring community hospitals (currently owned by local NHS organisations) and charging high market rents, in order to help maintain the buildings.

I held the demonstration on 21 May, as I am outraged by the news that NHS Property Services is to help itself to Ottery Hospital and 11 others in Eastern Devon. NHS PS has a remit for selling off hospital buildings that are “surplus to requirements.”

Mr Swire unexpectedly turned up at the protest, which he is quite entitled to do and asked to address the crowd after me, which I readily agreed to.

His response (which received heckling and jeering from the crowd) largely related to claiming that Ottery Hospital is entirely safe and that NHS PS wouldn’t and couldn’t sell it off.

My question, which I have asked repeatedly of NHS PS and of Mr Swire – what happens if the local NHS (which is around £80m in debt) can’t pay the rent, still remains unanswered.

My request to NHS PS, which has offered me similar assurances to Mr Swire, to view the draft terms and conditions of the contract, so I can satisfy myself that Ottery Hospital’s building is safe, has been refused.

I am reliably informed that elsewhere in the country community hospital buildings acquired by NHS PS have remained shut, with health clinics having to be held in church halls because of unaffordable rents, totalling around £500,000 a year. Before being seized by NHS PS, local health trusts owned the buildings so no rent was payable.

In Ottery’s case local people raised around £250,000 just 20 years ago to assist with the new hospital building.

Yet Mr Swire has suggested that the community should take out a long term lease in order to protect the hospital – from his own government?

The fact that the responsibility for maintaining community hospital buildings is now shifting from the local NHS to a politically appointed government minister, is also very relevant and has worrying implications.
So that’s the background. What has Mr Swire asserted since?

Well, firstly, he has accused me of “scaremongering” and “weaponising” the issue for my “own political advancement.”

I will not lower myself to respond to these silly comments.

He then goes onto claim that Budleigh Salterton is a good example of a community hospital turned into a health hub … but omits to mention that Budleigh Salterton Hospital remains shut because of ownership issues wrangling related to NHS PS taking over the hospital later this year and charging unaffordable rents!

Our MP’s derisory response to the problem doesn’t end here. Mr Swire has even insulted all the protesters at my demonstration on 21 May. He announced in his column in the East Devon press two weeks ago, also reproduced on his blog, that the residents who attended were a “left leaning pack that follow Councillor Claire Wright.”

Ottery St Mary Town Council is so angry about this remark that it will write to Mr Swire to complain.

I intend to fight the very dubious intentions of NHS PS all the way. This is just the beginning.

NHS Property Services is on the agenda at Devon County Council’s health and wellbeing scrutiny committee (of which I am a member) on Monday 20 June at 2pm. Please come along to County Hall and observe or watch online via the council’s website if you would like to know more. If you wish to address the committee you will need to register asap.

Some constituencies have MPs who fight their corner. It is a shame that East Devon’s MP is only interested in defending the indefensible actions of his government, which appears to be on a mission to degrade the NHS further each year.

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East Devon Watch

Posted on

1 Apr 2016

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Accountability, Devolution, Health and Social Care (local)

Devolution: how can you devolve health care when it’s already been devolved?

So, healthcare for Devon, Somerset, Torbay and PLYMOUTH is to be devolved to the new LEP.

Torbay already has its own integrated care scheme:

Pioneering the next steps in integrated care in Torbay and South Devon

Now, Plymouth gets its own (different) system financed by business rates.

How do you devolve two devolved systems to a new over-arching system – where only one person on the 20-member LEP has a health background?

Re-inventing the round wheel to make it square in the name of efficiency, or perhaps growth – who knows?

“Plymouth has been chosen to pilot the Government’s new devolved health funding model, as the city’s public health chief takes a leading role in the national roll-out.

Following a meeting between MPs and Public Health England (PHE), the city has been chosen as one of the first in the country to fund health services using only income from business rates.

Plymouth’s director of public health, professor Kelechi Nnoaham, will also sit on PHE’s national planning team for the initiative to help monitor the impact of the new system.

The announcement marks the latest stage in the Government’s efforts to devolve revenue-raising powers. Councils have already expressed concerns about the impact of cuts to central grants and plans to fund services solely through locally-generated taxes.

Plymouth is already among the lowest-funded authorities in terms of public health grants, with an average spend per person of £47. But the council suggests prof. Nnoaham’s place on the national panel for the scheme will ensure the city’s interests are represented.

The council has been campaigning for fairer funding for public health in Plymouth for some time and has been lobbying at the highest level,” a spokesman said.

“The unfair funding of public health was also highlighted by the Plymouth Fairness Commission.

“Our director of public health will be able to represent the interests of cities such as Plymouth. He has a strong professional reputation and will be able to ensure Plymouth influences national policy.”

The meeting with PHE chief executive Duncan Selbie was arranged by Plymouth Moore View MP Johnny Mercer. Mr Mercer has been campaigning on the issue of public health funding since his election in May, describing the local variation in grants – which sees some councils receive up to £185 per person – as “outrageous”.

He said he was “delighted” that Plymouth would have an opportunity to shape the new system at a national level.

“Public health funding was one of the first things I picked up on after being elected last year,” he said. “I wrote my first letter to Jane Ellison MP, Parliamentary Under Secretary for Public Health, in June and have attempted to keep up the pressure in correspondence and on the floor of the House ever since.

“I think we still have a lot of work to do, but I am delighted we have the opportunity to influence thinking around business rates retention in respect of public health funding. And frankly, I could not think of a more intelligent and impassioned advocate than Kelechi.”

http://www.plymouthherald.co.uk/new-public-health-pilot-address-Plymouth-s/story-29033918-detail/story.html

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The man David Cameron just put in charge of the government’s Brexit policy (see post directly below)

Oliver Letwin books andpamphlet:

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