DCC Health Scrutiny Committee – not fit for purpose

The DCC Health Scrutiny Committee lurches from poor practice to bad practice to utter chaos under the continued Chairmanship of Sarah Randall-Johnson

Can you imagine saying you will vote against questioning NHS Property Services about their intentions on the future of community hospitals which they now own “because they might not come”! And Randall-Johnson saying she is “not aware of any threat to any community hospital!!!

[CCGs have been offered match funding from the government for any properties sold in their areas]
http://www.mirror.co.uk/news/politics/naylor-plan-outline-sell-nhs-10544577
http://www.property.nhs.uk/asset-management/

Claire Wright’s Blog:

NHS Property Services will be invited to attend the next Health and Adult Care Scrutiny Committee in January.

But my simple request prompted a debate lasting over half an hour, at Tuesday’s meeting (21 November).

The lengthy and baffling discussion gave a poor impression of the committee in my view, with some Conservative councillors claiming confusion and dismissing the proposal several times as “premature.”

It all started off with a presentation to the committee by Independent councillor, Martin Shaw, under the final work plan agenda item.

Cllr Shaw rightly pointed out how many people were concerned about the potential loss of the hospital buildings, that they had put their own money into them and still there was no clarity over their future, yet NEW Devon CCG were (or at least would very soon be) paying large sums of money in rent each year when previously they owned the buildings outright.

NHS Property Services, a private company wholly owned by the Secretary of State for Health, set up under the Health and Social Care Act 2012, acquired the ownership of 12 community hospitals in Eastern Devon at the beginning of this year.

Given that the NEW Devon CCG is one of three most financially challenged health trusts in the country and must make huge cuts to try and stem a deficit of over £400m by 2020, people’s concerns about the future of the hospitals are very valid.

Following my proposal to invite NHS Property Services to the January meeting, chair, Sara Randall Johnson said there was a full agenda for the next meeting so it may not be possible to include it. She said that she was not aware that there was a threat to any community hospital.

Liberal Democrat, Brian Greenslade said NHS PS had been invited previously but questions had been remained unanswered and so should be invited again.

Conservative, Phil Twiss, who represents Honiton which has lost its own hospital beds, claimed in a number of long statements that it was “premature” to invite the company because the future of the buildings had not yet been decided.

He later added that they wouldn’t come anyway.

I replied that waiting until the March meeting was far too long and could mean that decisions were already made. Surely we need to talk to NHS PS and the CCG before their decisions?

I attempted to explain again why it was important we invited the company to the January meeting.

But apparently confusion reigned.

Conservative members became very fixated with the legacy issue, even though I had made it clear that it was about questioning NHS PS and the CCG about their plans on the future of community hospitals and the legacy issue was only part of that.

Chair, Sara Randall Johnson, suggested holding a meeting first to agree some questions to ask NHS PS. I have not seen this approach in my four and a half years as a member of the committee.

I had to make my proposal numerous times, while one or two persistent Conservative members continued to challenge it.

There was an amendment by Liberal Democrat, Nick Way, who wanted a spotlight review into the issue as well.

Phil Twiss then changed his tack and claimed there was no point in asking the company to attend as they wouldn’t come. He was in favour of a spotlight review instead (spotlight reviews are held in private).

But when the vote finally was taken, it was on the spotlight review amendment and not my original proposal to invite NHS PS to the next meeting …

I tried to intervene. Fortunately, the officers corrected matters… and then the majority of the committee voted in favour of my proposal. Finally.

My proposal couldn’t have been more straightforward or uncomplicated. It was entirely within the committee’s remit.

It was also within a couple of hours of hearing the county solicitor’s presentation about how scrutiny should do its job properly. Or be culpable. See this blogpost here – http://www.claire-wright.org/index.php/post/devon_county_council_solicitor_tells_health_scrutiny_committee_you_have_a_v

Here’s the webcast. It is the final item on the agenda – https://devoncc.public-i.tv/core/portal/webcast_interactive/302658

Pic: Me exasperated!”

http://www.claire-wright.org/index.php/post/nhs_property_services_will_be_invited_to_next_devon_county_council_health_s

Save (what’s left of) Axe Valley hospitals hits the headlines

Things MUST be bad in the local NHS if they hit the front page of the Midweek Herald!

“Axe Valley health hub plan launched as campaigners fight hospital sell off”

“Campaigners will continue to fight plans to sell off Seaton Hospital and to support plans for a new health hub for the Axe Valley. …

[Independent East Devon Alliance] County councillor Martin Shaw [Seaton and Colyton] said: “Forty campaigners from the Axe Valley area met in Seaton this week to review the state of the campaign for the local hospitals.

“I told the meeting that while the battle to save Seaton’s hospital beds had been lost, it had put Seaton on the map in the forthcoming discussions about health services in the area.”

Mayor of Seaton, Cllr Jack Rowland, said that a meeting to set up a steering committee for an Axe Valley Health Hub would take place shortly.

He was encouraged that the Royal Devon and Exeter Hospital Trust was putting resources into this and he also pointed out that more than fifty services involving over a hundred staff were still based at the hospital.

Campaigners will continue to fight plans to sell off Seaton Hospital and to support plans for a new health hub for the Axe Valley.

In August, a vigil was held outside Seaton Hospital as the beds inside the hospital were closed, as protesters waved banners, shouted “shame”, and expressed their anger and sadness outside Seaton Hospital as the controversial closures of community hospitals began.

Plans to remove the beds from Exeter, Seaton, Honiton and Okehampton community hospitals have been met with strong opposition since they were confirmed in March.

The North, East and West (NEW) Devon Clinical Commissioning Group (CCG) said the move will see more people being given care at home and save £2.6million.

Although the battle to save the hospital beds has been lost, a new campaign though has been set up in the Axe Valley area to support the development of a health hub in the region.

County councillor Martin Shaw said: “Forty campaigners from the Axe Valley area met in Seaton this week to review the state of the campaign for the local hospitals.

“I told the meeting that while the battle to save Seaton’s hospital beds had been lost, it had put Seaton on the map in the forthcoming discussions about health services in the area.”

He was encouraged that the Royal Devon and Exeter Hospital Trust was putting resources into this and he also pointed out that more than fifty services involving over a hundred staff were still based at the hospital. ‘Don’t let anyone say the hospital is closed’, he said.

The meeting, chaired by Paul Arnott of the East Devon Alliance, agreed that it was necessary to establish which health services could most usefully be based in Seaton and Axminster hospitals, and this might involve canvassing the views of local residents and a number of people present offered to help with this.

The meeting decided to set up a new Axe Valley Hospitals Campaign to support the development of a health hub around the two hospitals and to oppose any proposals to sell off hospital sites.”

http://www.devonlive.com/news/health/axe-valley-health-hub-plan-699423

DCC has no evidence that new way of working – is working!

From the blog of Independent East Devon Alliance county councillor Martin Shaw (Seaton and Colyton) who fought valiantly with Independent DCC councillor Claire Wright to save our community hospital beds, which was defeated by Conservative block voting for the closures.

“There is new evidence that Brexit is adding to the NHS’s chronic staff shortage. Far fewer nurses and doctors from other EU countries are coming for jobs in the UK, while many of those already here are leaving – or plan to leave.

Locally, the RD&E is struggling to recruit care workers for the ‘new model of care’ to replace community beds. Council officers freely admit that Brexit is making Devon’s social care recruitment crisis worse, and at the County Council meeting on 5th October I asked for figures on the number of people from other EU countries in health, social care and education in the county. The answer was that the Council can’t produce them – in a follow-up question I asked the Cabinet to remedy that, and also to reassure EU citizens that they are valued here.

Many people voted for Brexit partly to help the NHS – but are now realising that it is doing the opposite. Of course the Leave campaign said that it wanted to allow professionals like nurses and doctors still to come to Britain – it was more the unskilled workers it wanted to stop (although where that would leave our farming and tourism industries is another problem). What this argument overlooked is that doctors and nurses who move here are not just making a decision about a job – they are looking at whether the country is open and welcoming. The message that Britain didn’t want foreigners went out loud and clear to the people we need to keep our NHS going, as well as everyone else.

Leave voters rightly hoped to see more money go to our underfunded NHS. However it is now universally recognised that the Leave campaign’s idea of saving ‘£350 million a week’ was utterly misleading. Much of the money never goes to the EU (because of the rebate negotiated by Margaret Thatcher) and most of the rest comes back to support things like agriculture, scientific research and regional development in places like the South West – expenditure that the British government will need to replace. Recently it has become clear that the economy has fallen back since the referendum to the extent that the Government is already losing much more in tax revenues than it will eventually save by leaving the EU. So the NHS has no hope of gaining money from Brexit, and is hit on the staffing side too.”

New evidence that Brexit is harming NHS staffing – but Devon County Council has no figures for the local situation

DCC Tories torpedo Devon NHS

“PRESS RELEASE
Yesterday the Conservative Party machine defeated my final attempt to get Devon County Council to take action over the closure of community hospitals beds. My motion, seconded by Claire Wright, asked the Health Scrutiny Committee to look again at the issues it failed to scrutinise properly in July, and asked the Council to write to the Secretary of State for Health to alert him to our concern about hospital beds. I highlighted widespread NHS concern that there will be too few beds if there is a flu epidemic this winter. My speech is available here and you can watch it and the debate in the webcast (beginning at 2.18).

The Tory response was an amendment, moved by the leader, John Hart, which took the guts out of the motion. Despite all the evidence to the contrary, it said that Health Scrutiny had ‘extensively considered the issues and concerns from members of the public, elected members and others, including medical professionals, all matters relating to the closure of some community hospital beds in Honiton, Okehampton, Seaton and Whipton.’

Instead of my proposal to write to the Secretary about the beds closures, the amendment proposed to write ‘seeking reassurance that appropriate funding is provided by government to deliver the necessary health and social care services in Devon’. Not a dicky bird to the minister about community hospital beds, the whole point of the debate.

In reply I told the Council (at 3.10) that if they passed this amendment, they would be ignoring East Devon opinion just like Kensington & Chelsea Council ignored the residents of Grenfell Tower; and the Conservative Group as a whole would have made itself responsible for the failure to properly scrutinise the hospital bed closures.

The result

Although they were not formally whipped, 40 Tories fell dutifully in line to support the amendment. There were 16 votes against (these were Liberal Democrat, Labour, Independent and Green members, together with only one Conservative, Ian Hall of Axminster).

Claire made a valiant attempt to put some guts back into the motion, with another amendment – but the Tory machine squashed that too.

Martin Shaw
Independent East Devon Alliance County Councillor for Seaton & Colyton

DCC Tories fail, yet again, to do the right thing on our NHS

“Martin Shaw and Claire Wright were voted down… [at today’s health scrutiny committee, see below] shame on Devon County Council! Every single Tory Councillor with the exception of one voted against Martin’s motion – they put party politics above their communities interests once again.
People need to know what they did.”

Ind. East Devon Alliance Councillor Martin Shaw’s speech to DCC committee today

“Speech by County Councillor Martin Shaw (Independent East Devon Alliance, Seaton and Colyton), moving to send the issue back to Health Scrutiny, at Devon County Council, 5 October 2017:

“I represent a large division in East Devon. 2 years ago Seaton, Axminster and Honiton hospitals had in-patient beds, universally appreciated by patients & doctors, and supported by local communities. Today large parts of each hospital lie empty – nurses and other staff are dispersed – volunteers have been told they are no longer needed. We don’t even know whether the buildings will survive as centres of health services or be sold off.

This is the biggest crisis East Devon & Okehampton have faced in many years. Local communities have been united in their opposition; councillors of all parties have opposed the decisions.

After a biased consultation and flawed, unjust decisions, we looked to the Health Scrutiny Committee to hold NEW Devon CCG to account, and they have failed us. My proposal today is not a motion of NO confidence in any councillor or party. It is a motion to RESTORE confidence in this Council’s ability to represent Devon communities and stand up for their interests.

The tragedy is that Health Scrutiny started sensibly by asking the CCG 14 questions, in order to decide whether it should use its legal power to refer their decision. This proposal had cross-party backing, with the support of more Conservatives than members of any other party. A minority of the committee were, however, determined from the beginning to disregard public concern and voted not even to ask the questions.

The CCG replied to the questions but the Committee found their answers inadequate and wrote back detailing areas of concern. So far so good – a model of scrutiny. But things started to go wrong when the issue came to the new Health & Adult Care committee in June. The new Chair argued that members were insufficiently experienced to decide the issue and recommended delaying a decision until September 21st. It escaped no one’s notice that this was after the date given for permanent closure of the beds. It was seen as an attempt to prevent effective scrutiny.

Fortunately, the Committee agreed instead to a special meeting in July. For this meeting, the County Solicitor prepared a guidance paper outlining 6 issues outstanding with the CCG. Councillor Ian Hall, Councillor Mike Allen who is a Conservative District councillor, and others joined me in pressed the local communities’ case.

However the CCG gave a long powerpoint presentation which simply did not address most of the 6 issues, and before any debate could take place, Councillor Gilbert proposed there be no referral. In case anyone believed that he still wanted to scrutinise the issues, he made a point of emphasising that not referring would ‘save the committee a huge amount of work ’.

Councillor Diviani then told the committee that referral would be a waste of time, because ‘attempting to browbeat the Secretary of State to overturn his own policies is counter-intuitive’.

The Committee never discussed most of the remaining issues that the guidance paper had identified. By my reckoning, only 1 out of 6 was more or less satisfactorily addressed. Let me mention just one that wasn’t, the surprise decision to close Seaton’s beds, removing all provision from the Axe Valley. Neither the CCG nor any member gave any reason for believing this decision was justified – yet the committee voted for it anyway and the empty wards of Seaton hospital are the consequence.

There was no broad support for the anti-scrutiny motion: it was supported only by 7-6 ; 4 members abstained or were absent. The meeting was widely seen as an abdication of scrutiny. The Standards Committee says it ‘may not reflect well on the Council as a whole’. I would go further: it did not reflect well on this Council.

Since then, new evidence has shown that cutting beds to the bone brings great risks. The Head of the NHS, Simon Stevens, has called for more beds to be urgently made available this winter in face of a possible flu epidemic. Expert bodies like the Kings Fund, the College of Emergency Medicine and NHS Providers have backed the judgement that the NHS is cutting too far, too fast. These are new reasons to question the CCG’s plans.

This motion therefore proposes that

The Scrutiny Committee should look again at the issues which were not satisfactorily addressed.
The Council should tell the Secretary of State that the CCG’s decisions and the wider STP process have aroused great feeling in Devon, that people are not happy with either the decisions or the way they were made , and we are worried that we simply won’t have enough beds for the coming winter.
Finally, following a more constructive Health Scrutiny meeting on 21st September, this motion welcomes the Committee’s help in securing community hospital buildings.
Some of you may still wonder if Cllr Diviani was right, and all these proposals will be a waste of time. The answer to this is given in a recent letter from the Secretary’s own office: ‘As you may know,’ it says, ‘contested service changes can be referred to the Secretary of State, who then takes advice from the Independent Reconfiguration Panel.’ So a referral is not something the minister deals with personally; it is a legally defined procedure.

The letter continues, ‘However, as you are aware, Devon’s Health Scrutiny Committee … passed a motion … in favour of not referring the CCG’s decision to the Secretary of State.’ Cllr Diviani suggested that referral was pointless because of the minister’s opinions: the minister’s office implies it WOULD be meaningful, if only Devon would take action.

I ask you to restore this Council’s reputation and take the action which it is within your power to take, even at this late date, to save our community hospital beds.”

DCC Ind. East Devon Alliance Councillor Martin Shaw will try again to get DCC to see sense on bed closures

“PRESS RELEASE
Tomorrow (Thursday) Devon County Council will discuss a new call to review the controversial closure of beds in community hospitals in Honiton, Okehampton, Seaton and Whipton.

I have been told my motion will be discussed, rather than referred to Cabinet as is normal with most motions.

The motion proposes to redress the widely perceived failure of the Health Scrutiny Committee to properly scrutinise NEW Devon CCG’s decisions, which has allowed the CCG to go ahead with the closures.

The motion asks Health Scrutiny, which alone has legal power to refer the decision, to look again the outstanding issues, while at the same time committing the Council to alerting the Secretary of State to the disquiet in the County over the issue.

The motion also highlights the urgent call by Simon Stevens, Head of the NHS in England, to free up more hospital beds in view of the danger of an extreme flu season this winter.

I will issue the text of my speech tomorrow morning.

Martin Shaw
Independent East Devon Alliance County Councillor for Seaton & Colyton”

DCC EDA Independent Councillor joins DCC independent Councillor Claire Wright as one of the few NHS champions at DCC

“After the failed Health Scrutiny Committee meeting in July – which has led to repercussions in the County’s Standards and Procedures Committees as well as at EDDC – the full Devon County Council will be asked to look again at the issues on Thursday 5th October. I have proposed the following motion, which Claire Wright will second:

The County Council regrets the failure of the Health and Adult Care Scrutiny Committee on 25 July 2017 to be seen to scrutinise the decision of NEW Devon Clinical Commissioning Group to close community hospital beds in Honiton, Okehampton, Seaton and Whipton, especially in the light of the subsequent urgent recommendation by the head of the NHS in England, Simon Stevens, which is supported by evidence from the Royal College of Emergency Medicine and the King’s Fund, that more beds need be made available for the coming winter.

Noting also the Standards Committee’s conclusion that events at the Scrutiny Committee meeting ‘may not reflect well on individual members of the Council or upon the Council as a whole’, its recommendations for the Committee’s Chair and its general recommendations to both members and chairs of Scrutiny Committees, the County Council therefore

requests the Health and Adult Care Scrutiny Committee to scrutinise those issues identified by the County Solicitor in her paper for 25 July which were not directly and fully addressed at the Scrutiny Committee in that meeting;
consistent with the Council’s ‘community champion’ role, alerts the Secretary of State to the strength of feeling in the locality at the overall STP process throughout the County and the significant numbers of objections made by the public to the CCG’sproposals and that in the interests of democracy and democratic accountability he might wish to satisfy himself that all relevant process were properly undertaken and assessed and that the CCGs subsequent decisions are supported by the evidence; and
welcomes the agreement of the Health and Adult Care Scrutiny Committee to examine, subject to the advice of the County Solicitor, means of safeguarding community hospital buildings throughout Devon as facilities for the provision of place-based health services.

Seaton and Axminster – combined health hub?

As I have reported before, Seaton Town Council, the League of Friends and I have been discussing the future of Seaton Hospital in the light of the removal of the beds. Full details of the proposals have not been finalised, so I can only quote the report of Councillor Jack Rowland, Mayor of Seaton, to next Monday’s Town Council:

‘The next campaign is to ensure that the site is retained with a compelling case for retaining the existing services and extending these. To this end I attended a meeting on 6 September to discuss the next steps. I cannot give fuller details at this stage, but broadly the idea is to set up a Steering Committee for an Axe Valley Health Hub and to work in conjunction with Axminster to build a case for retaining both sites with complementary services.’ “

After the failure of the July Scrutiny meeting, I am asking Devon County Council to look again at hospital bed closures on 5th October

DCC EDA Independent Councillor Shaw asks LEP CEO killer question

The question

When will the Heart of the South West LEP offer something to small town, rural and coastal Devon?

The response:

“This was the question I asked Chris Garcia, of the Heart of the South West LEP, when he appeared before the Corporate Infrastructure and Regulatory Services Scrutiny Committee (CIRS) at Devon County Council yesterday. Mr Garcia said that Government funding was geared mainly to urban areas, but the LEP has a ‘rural growth commission’ which will publish a report shortly. I shall look out for it.

Mr Garcia didn’t reply, however, to my criticism that the LEP is itself skewed by the ‘white elephant’ new nuclear power station at Hinkley C in Somerset. This project, rashly endorsed by Theresa May who had a chance to halt it, will cause British consumers pay over the odds for electricity for decades to come, based on an unproved type of nuclear station which is not supported even by many who believe nuclear energy is necessary for national energy needs, and in the control of French and Chinese state companies! As renewables get cheaper and electric storage becomes viable, this is a project we don’t need. True, it will bring some jobs to Somerset, but not to most of Devon.

Mr Garcia came with a powerpoint and brandishing the LEP’s latest glossy annual report. I asked that in future, we had proper written reports circulated in advance which members could scrutinise.

Mr Garcia didn’t mention the word ‘devolution’. HoTSW is leaving all that to Devon and Somerset county councils, who are apparently now planning to establish a Joint Committee. What that will involve is something else county councillors will need to scrutinise carefully.”

When will the Heart of the South West Local Economic Partnership (LEP) offer something to small town, rural and coastal Devon?

“Tories block recording concerns over biggest ever planned health service cuts in Devon”

Oh, how different it will be if (when) Tories lose control of DCC. We will then hear Twiss and his party colleagues saying EXACTLY what Claire Wright is saying!

Party politics sucks. More Independents needed – urgently.

From the blog of Claire Wright:

“.. And the County Solicitor will be called to address the committee to remind it of its responsibilities.

Devon County Council conservatives blocked my proposal yesterday to record significant concerns over the biggest cuts facing Devon’s health service in living memory.

Sonja Manton from NEW Devon Clinical Commissioning Group gave an update on the plans to slash around £500m by 2020, as part of Devon’s Sustainability and Transformation Plan (STP).

The county’s STP is one of 44 across the country and is the government’s main programme of major cost cutting and centralisation in the NHS, to stem a £30bn shortfall by 2020.

I asked a number of questions mainly on staffing, budgets and buildings, along the following lines:

What are the vacancies and how do you plan to fill them and when do you plan to make redundancies (which has been previously hinted at)?

The answer was woolly (and no amount of pushing would encourage Dr Manton to reveal more). It contained no information on numbers, but she did mention that there is a 30 per cent turnover rate across Devon, in home care staff and that 75 per cent of the NHS budget is spent on staffing.

Next I asked whether pregnant women would still have a genuine choice where to give birth, as three community maternity units at Okehampton, Tiverton and Honiton were set to close (two have already closed temporarily due to staffing issues).

The answer was that the new service would meet national guidelines, so I pushed and asked whether pregnant women would be able to have a choice of a midwife led unit and how far they would have to travel. The answer was that there will be a new midwife led unit at the RD&E, adjacent to the consultant led unit.

So essentially women from all over Devon will soon have to either have a home birth, or travel to Exeter to give birth, whether that’s at a midwife led unit or a consultant led unit. There was a bit of a disagreement about me saying the current midwife led units were closed, despite the announcement having already been announced that this was the intention and two being temporarily closed due to staffing pressures.

Next I asked how many more beds were planned to be cut.

More prevarication.

I pushed. Was the figure of 600 bed cuts recognised, which was the broad figure in the first draft of the STP?

Yes this figure was recognised but it depended on a raft of issues.

Finally, I asked about the selling off of redundant estate. How many, where and when? Another non answer ensued. It was the next piece of work.

Entirely frustrated at the refusal to answer questions, not because I believe, the answers are not known but because there is a total refusal to get into any detail whatsoever, I expressed my complete frustration and disappointment at the answers. It made no difference.

Other councillors asked other questions.

At the end of the debate I proposed a resolution that the committee express significant concerns over the STP, its potential effect on patient care and the lack of transparency so far.

I called for urgent information on staffing, beds, buildings and budgets, in particular.

The proposal was seconded by Chair, Sara Randall Johnson, who added that a piece of work would be done on this.

Unfortunately, my wording appeared to upset the conservative group. Cllr Philip Sanders said he didn’t like that I had said the process appeared not to be transparent and wanted this word deleted. I replied that that it was entirely justified and refused to amend my proposal.

But fellow Conservative, Phil Twiss, wanted ANY mention of concerns deleted.

He said: “We don’t need the emotional language.”

Three years ago, Cllr Twiss reported me and this blog to the police cyber crime unit. You can read about it here, if you like – http://www.claire-wright.org/index.php/post/eddc_tory_whip_reports_me_to_the_police_for_a_comment_on_this_blog

Cllr Twiss then proposed that ALL my words were deleted, simply retaining the section that relating to a task group being set up.

This was voted through by the vast majority of the Conservative group.

Letting down every single resident in Devon who relies on the NHS.

Yes, I think that’s everyone.

Ambulance Trust response targets are failing and RD&E unable to discharge its patients in good time

Later in the meeting we were examining the performance review.

The South West Ambulance Trust which used to meet the national target of eight minutes largely without a difficulty, are now significantly under target. Only 59 per cent of calls were answered within eight minutes, across Northern, Eastern and Western Devon, in July of this year. The target is 75 per cent.

Lives are surely being put at risk. Certainly news of the failures are hitting the local media.

The narrative attached to the graph claimed that the reason was the rural nature of the South West. Yet the South West has been rural for years and this wasn’t a problem previously. Of course there have been cuts to budgets, and reductions in the number of ambulances so that is more likely to be the cause of the failure.

Problem with delayed discharges at the RD&E

Similarly, the RD&E was shown to have a significant problem with delayed discharges.

In June this year a daily average of 66 beds were occupied by patients who were well enough to go home.

It was obvious from the graph that the problem was clearly way out of kilter with other local NHS trusts.

This was largely to do with major staffing problems in the care sector, an officer confirmed.

of course it is these staff among others that we will rely on, to look after people in their own homes following community hospital bed cuts.

I proposed a resolution that the committee record its concerns at the ambulance response rates and the high level of delayed discharges at the RD&E and invite both trusts to the next committee meeting.

I had to argue with the chair that the proposal should retain the bit about recording concerns, before it was seconded by Cllr Brian Greenslade.

One of the Labour councillors was unhappy with me mentioning the RD&E at all in my resolution because she was chairing a piece of work looking at delayed discharges. I tried to point out that the resolution supported her work but she was adamant …

Then Cllr Twiss started up again. He said he didn’t like my wording and that I was simply making a statement that “looks good in the press.”

I reminded Cllr Twiss that the committee is legally constituted to scrutinise health services on behalf of the people and our job is to hold the health service to account. In fact such words had been used recently in a standards committee hearing minutes.

Anyone who is familiar with the basic requirements of an audit trail will recognise the importance of the committee recording concerns about service failures in this way.

I told Cllr Twiss that I intended to ask in the work programme agenda item, that the county solicitor attends the next committee meeting and outlines our responsibilities.

The final amendment removed my words about concerns about the RD&E’s delayed discharges but retained the words about the ambulance trust target failure.

So Ambulance Trust representatives will be invited to the next meeting.

I have certainly heard anecdotally that things are very challenging indeed within the Trust, with too few ambulances and low staff morale.

I duly asked in the final agenda item for the County Solicitor to attend the next meeting to remind the committee of its remit.

Some councillors appear to be in sore need of training.

Playing political games with health scrutiny resolutions is a dirty and unacceptable game.

NHS Property Services and buildings

Cllr Martin Shaw spoke to a report he submitted to the committee on this. The upshot will be that a sub group will examine the future of community hospital buildings.

The speaker itemised webcast can be viewed here – https://devoncc.public-i.tv/core/portal/webcast_interactive/301904”

http://www.claire-wright.org/index.php/post/tories_block_recording_concerns_over_biggest_ever_planned_health_service_cu

EDA DCC Councillor Martin Shaw asks council to scrutinise ownership and governance of community hospitals

PRESS RELEASE from DCC Councillor Martin Shaw (Seaton and Colyton):

Tomorrow I am asking the committee to consider a proposal on ‘Ownership, Community Stakeholding and the Governance of Community Hospitals’, the briefing note for which is copied below and is self-explanatory:

Ownership, Community Stakeholding and the Governance of Community Hospitals

Community hospitals in Devon have always been built and maintained with a high degree of community involvement and support. In many cases, local communities took the initiative to build the hospitals and raised a substantial part of the original funding, or even the entire funding of additional wings and facilities, as well as contributing to staff and other running costs, the introduction of new specialist services, etc.

Unlike Private Finance Initiatives undertaken in partnership with private companies, these ‘community finance initiatives’ – which sought no profit from their investments other than the improvement of the facilities and services they enabled – appear not to have secured their interests in the hospitals they helped to build. The Leagues of Friends and others who raised funds for hospitals trusted that their investments would continue to be used for the benefit of place-based health services in their local area.

Since the 2012 Health and Social Care Act, however, the organisation of the NHS has changed and the ownership of NHS buildings is in the process of being transferred to a new company, NHS Property Services, wholly owned by the Secretary of State and charged with managing the NHS estate in line with national priorities. NHS Property Services is enabled to sell off parts of the estate and to charge NHS organisations market rents for their use of NHS buildings.

This change creates dilemmas for local communities which have invested in Devon community hospitals. Clearly Leagues of Friends and other local bodies, including town and parish councils as representatives of communities which have raised large amounts of funding, can be considered ‘stakeholders’ in community hospitals. However these community stakeholders appear not to possess formal rights in the ownership and governance of the hospitals.

The proposal is that the Health and Adult Care Scrutiny undertake an investigation into

1. The changing ownership and governance of community hospitals in Devon and its implications.
2. The historic and ongoing contributions of local communities and Leagues of Friends to funding the hospitals.
The purpose of this investigation would be to address the question of
3. How community stakeholders’ interests should be secured in the future governance of community hospitals.

It is envisaged that in the course of this investigation, the Committee would both collect evidence and invite expressions of views from all stakeholders, including both local community organisations and NHS bodies, including NHS Property Services.

Martin Shaw
Independent East Devon Alliance County Councillor for Seaton & Colyton”

Independent councillor challenges Councillor Mike Allen’s letter on Tories and NHS

Independent East Devon Alliance councillor Martin Shaw (Seaton and Colyton) makes this observation on EDDC Tory councillor Mike Allen’s attempt to distance other EDDC and DCC councillors from Leader Diviani’s actions which led to the vote of no confidence meeting at EDDC tonight.

(Assemble Knowle 5.30 pm if you wish to make your presence felt for this meeting)

“It is not credible to say that Diviani acted alone – he may not have consulted other district councils, but remember that three of the East Devon Tories on Health Scrutiny (Randall Johnson and Richard Scott as well as Diviani) voted for ditching the hospital beds, with only Twiss against and Jeff Trail absent. Even at the time of the County Council elections in May, E Devon Conservatives advocated ‘bedless hospitals’, so Mike Allen’s story doesn’t add up. If they back Diviani tonight they will be consistent with their party’s betrayal of Honiton and Seaton.”

Letter referred to in post below and above:

Councillor calls for Randall-Johnson resignation

PRESS RELEASE

Devon County Council’s Health and Adult Care Scrutiny Chair, Councillor Sara Randall Johnson, should immediately consider her position following the stinging rebuke issued to her by the Council’s Standards Committee. The Council should also act to restore the credibility of Health Scrutiny, since its failure to fully scrutinise the removal community hospital beds in Honiton, Okehampton and Seaton has destroyed public confidence in its activities across a large swathe of Devon.

At its meeting on 29 August, minutes of which are published today, the Standards Committee agreed that while Cllr Randall Johnson had not broken the Members’ Code of Conduct, she should ‘be strongly reminded of the importance of the work of scrutiny committees – reinforcing the value of neutrality in scrutiny both generally and in calling the “health service” to account – and the need to be seen to be even handed and scrupulously fair, recognising that failure to do so may be perceived as a deliberate act.’

The call for a Scrutiny Chair to ‘be strongly reminded of the importance of the work’ of her committee, and of the value of neutrality and being seen to be even-handed and fair, is unprecedented and should lead Cllr Randall Johnson to immediately consider her position. There is no public confidence that she will lead the committee to carry out full and impartial scrutiny of NHS decision-making.

The Standards Committee also ‘accepts that the events of the Health and Adult Care Scrutiny Committee meeting on 25 July 2017 may not reflect well on individual Members or upon the Council as a whole, and further recognises that the perception gained by persons present at the meeting or subsequently viewing the webcast is not that which would have been desired’.

This stark acknowledgement of the damage done to Devon County Council’s reputation also requires early action by the Council to reassure the public that the Committee will do its job properly in future and protect the NHS in Devon.

The Scrutiny Committee ignored the views of local communities and their representatives and has allowed the CCG to get away with damaging cuts. The Council must now consider how to restore people’s faith that it will protect all our community hospitals in the future. I shall ensure that this is discussed when the Council meets on 5th October.

Martin Shaw
Independent East Devon Alliance County Councillor for Seaton & Colyton”

Honiton Hospital beds closed – motion of “no confidence” in EDDC Leader 13 September 2017 6pm

Susie Bond, EDDC Independent Councillor, Feniton reports”

“This morning I attended a vigil outside Honiton Community Hospital. It was called to mark the end of inpatient care in the town. It was a sad day, as it now means that there are no inpatient beds in the hospitals in Seaton, Axminster, Honiton and Ottery St Mary.

I wasn’t sure what to expect … it’s a Bank Holiday and the weather was glorious … so I half expected to be there with just a handful of people.

I was wrong.

The event had been organised by Honiton Patients’ Action Group … a well-organised and furious bunch of people.

A group of about 50 turned up, armed to the teeth with placards, happy to vent their feelings to the local press about the parlous state of future community health provision.

Among those present this morning was Cllr Martin Shaw (county councillor for Seaton and Colyton) who spoke about his grave concerns for health provision. He had also addressed Devon County Council’s Scrutiny Committee meeting in July (https://seatonmatters.org/2017/07/26/the-health-scrutiny-committee-which-didnt-scrutinise/).

The decision to close the inpatient beds in Honiton had not been the subject of public consultation, so those present felt that this was sufficient cause for Devon County Council’s Health and Adult Care Scrutiny Committee to refer the decision to close the hospital beds to the Secretary of State, Jeremy Hunt. In turn, he would have had to refer the decision to the Independent Reconfiguration Panel (which describes itself as ‘the independent expert on NHS service change’).

Had that decision been made at their July meeting (https://devoncc.public-i.tv/core/portal/webcast_interactive/293466), those present at the vigil today would probably have still been worried about their future health care, but at least they would have felt that every avenue open to them had been explored.

Instead they were denied this last opportunity by political shenanigans of epic proportion.

I watched the webcast of the July meeting of DCC Health Scrutiny Committee (http://www.devonlive.com/news/devon-news/conduct-committee-members-investigated-devon-312213) and was frankly appalled at the charade being played out before my eyes.

Questions have been raised about how the meeting was conducted and the Standards Committee at DCC meets tomorrow to decide if the complaints are well founded.

Meanwhile, members of East Devon District Council have expressed dismay about the way an almost unanimous vote on a Motion expressing real concern about the conduct of the Clinical Commissioning Group was ignored and have called an Extra Ordinary Meeting of full Council to discuss a Motion of No Confidence in the leader, Cllr Paul Diviani, who sat on Devon County Council’s Health and Adult Care Scrutiny Committee as a representative of the leaders of all the district councils in Devon.

Cllr Diviani effectively voted against referring the decision to close inpatients beds in Honiton to the Secretary of State and later admitted under robust questioning that he had not canvassed the views of the other leaders.

The Extra Ordinary Council meeting will be held on

Wednesday 13 September
at EDDC’s headquarters at the
Knowle, Sidmouth,
starting at
6 p.m.

Seaton DCC Councillor on that shameful DCC Health Scrutiny meeting – and Diviani’s disgraceful behaviour

“Councillor-Sara-Randall-Johnson (from this article):

Why did Devon’s Health and Adult Care Scrutiny Committee block the proposal to refer the closure of our beds to the Secretary of State?

The idea that the Chair, Councillor Sara Randall Johnson (left), was settling an old score with Claire Wright makes a nice story but overlooks the concerted Conservative position. The collusion between Randall Johnson and Rufus Gilbert – who rushed to propose a ‘no referral’ motion before Claire could move her motion to refer – was obvious to all, as was her keenness to persuade her colleagues not to have a recorded vote.

Equally striking, however, is that only one out of 12 Tories on the Committee – Honiton’s Phil Twiss – voted against Gilbert’s motion. The other 7 Tories who voted were all for allowing the beds to be closed; 2 who had reservations abstained; 2 more were (diplomatically?) absent. Whipping is not allowed on Scrutiny committees, but this gives a strong impression of a Tory consensus. Members who were uncertain of their support were unwilling to defy it beyond abstention. Twiss was obviously a special case, as the one committee member whose hospital will lose its beds.

Clearly the Conservative Group on DCC gave their East Devon members the main role in dealing with the Eastern Locality hospital beds issue when in May (with its return to Scrutiny looming) they made Randall Johnson chair and nominated two Exmouth members, Jeff Trail and Richard Scott, as well as Twiss as members of the Health Scrutiny Committee. With East Devon Tory leader, Paul Diviani, representing Devon’s district councils, 5 of its Tory members were from East Devon and only 7 from the other five-sixths of the Tory group.

East Devon Tories on the committee certainly lived up to their role on Tuesday. All except Trail voted, making half of all Tory votes cast on the committee and 3 out of 7 on the pro-CCG side. In contrast, only 4 of the 8 Tories from elsewhere in the county cast a vote on this crucial issue: East Devon’s Tories may have convinced themselves, but not their colleagues.

Paul Diviani spills the beans

With Randall Johnson preoccupied with timekeeping (except when the CCG were speaking), Scott silent and Twiss asking questions, it was left to Diviani to express the Tory rationale. He claimed to speak for Devon district councils as a whole, but has acknowledged that he had consulted none of the others. He was happy to defy his own Council, which has voted to keep hospital beds, and spoke for himself – and East Devon Conservatives.

Diviani’s caustic little speech deserves more attention than it has been given.

He started by saying that those who decide to live in the countryside expect diminished service, and must cut their cloth accordingly in current times – forgetting that many have lived here all their lives, or moved here long before the present Tory government arrived to savage the NHS.

‘Costs will always rise without innovation’, Diviani continued, forgetting that the ‘costs’ of community hospitals are rising particularly because of the Tory innovation which gave them over to NHS Property Services and its ‘market rents’.

‘Local decisions should be made locally’, he averred, overlooking the fact that Sustainability and Transformation Plans, Success Regimes and NHS property sales are all national initiatives forced on the local NHS – while NEW Devon CCG is so unrepresentative even of local doctors that only full-time managers (Sonja Manton and Rob Sainsbury) are allowed to present its case in public while its ‘practitioner’ figurehead, Dr Tim Burke, hides in a corner.

When, however, Diviani warned that ‘attempting to browbeat the Secretary of State to overturn his own policies is counter-intuitive’, he expressed the truth of the situation. The closure of community hospitals results from the determined policies of the Conservative Government. (Referral would have served the purposes of delaying permanent closures, embarrassing the Government and forcing its Independent Reconfiguration Panel to give an assessment of the issue.)

East Devon Tories are the Government’s faithful servants. ‘Don’t trust East Devon Tories’ over the hospitals, I warned during the County elections. How right have I been proved.”

East Devon Tories were central to ditching Seaton and Honiton hospital beds

Bed closures at Honiton and Seaton – the final stitch-up by Tory Councillors

Councillor Martin Shaw (EDA, Colyton and Seaton) reports:

[Names of those voters have been amended – it does not affect the result]

“The 7 councillors who voted NOT to refer the decision to close Honiton and Seaton hospital beds were:

Sarah Randall-Johnson
Paul Diviani (Leader of East Devon District Council, representing Devon district councils), and county councillors
Richard Scott (Exmouth),
Rufus Gilbert,
Sylvia Russell,
Paul Crabb and
Ron Peart.

The 6 councillors who voted against this motion, i.e. to refer the decision, were Claire Wright (Otter Valley, Independent), Brian Greenslade and Nick Way (Liberal Democrat), Hilary Ackland and Carol Whitton (Labour) and Phil Twiss (Honiton, Conservative).

Jeremy Yabsley (Conservative) abstained as did John Berry. Two other Tories,
Jeffrey Trail (Exmouth) and
Philip Sanders, gave their apologies.

Six public speakers, Cllr Roger Giles (Chair of East Devon’s Scrutiny Committee), Paul Arnott (Colyton), Cllr Jan Goffey (Mayor of Okehampton), Cllr Mike Allen, Bob Sturtivant and Stephen Craddock (Honiton), spoke eloquently against the closures for two and a half minutes each. County Councillor Ian Hall (Axminster) and I also addressed the committee for five minutes each.

Three representatives of NEW Devon CCG and the RD&E (who run the hospitals and are working with the CCG) were then allowed to make a very lengthy Powerpoint presentation and contribute freely to the discussion – which none of the public speakers, Ian Hall or I were allowed to do.

Claire Wright had prepared a detailed motion to refer the closures and had submitted it to the Chair before the meeting. However when debate began, Cllr Randall Johnson chose not to call Claire to speak but called Rufus Gilbert who immediately proposed the motion not to refer, which was quickly seconded by Sylvia Russell.

This blatant manoeuvre by the Chair meant that the committee never considered point by point, as Claire’s motion would have required it to, the 14 questions on which it had asked the CCG to satisfy it. Despite an excellent report from Hilary Ackland which concluded that the CCG had failed to convince, the Committee basically abdicated its scrutiny role and blocked a referral without discussing most of the objections which we had raised.

Claire and I are planning to complain about the way the meeting was handled. If you want to watch it, it’s online at

https://devoncc.public-i.tv/core/portal/webcast_interactive/293466.

Thank you all for your support for the hospitals over the last 9 months. Be assured, however, that this is not the end of the matter, since the CCG and RD&E are both developing ‘estates strategies’ which will centre on what to do with space freed up by the closures. “

Tories sacrifice Honiton and Seaton hospitals to party dogma

“By 7 votes (all Conservative) to 6 (2 Liberal Democrats, 2 Labour, 1 Conservative and Independent, Claire Wright), Devon County Council’s Health Scrutiny Committee today sealed the fate of the beds in the two hospitals (and Okehampton) by voting not to refer the closure of beds to the Secretary of State for Health.”

Tory majority sacrifices Seaton and Honiton hospitals at Devon Health Scrutiny

Tory voters – this is totally down to you.

EDA County Councillor Martin Shaw on Seaton hospital bed cuts

“PRESS RELEASE

Protestors from Seaton, Honiton, Okehampton and elsewhere in Devon will converge on County Hall again on Tuesday 25th July from 1 pm, before the special meeting of Devon County Council’s Health Scrutiny Committee at 2.15 which will decide whether to refer the closure of beds in the three hospitals to the Secretary of State.

NEW Devon Clinical Commissioning Group proposes to replace the beds with a new system of care at home. We shall be pointing out that:

The new system, which they have been developing only since March, has not been tested in winter, let alone a flu epidemic; it is uncertain that they will be able to staff it effectively over time given the complex travelling arrangements that it requires for medical as well as care staff.

The small number of beds (halved to 71) which they propose to retain across the 3 remaining community hospitals ignores the facts that East Devon has far more over-85s (the key users of community beds) than other areas of Devon and that these numbers are projected to treble in the next two decades.

The remaining beds will not be distributed in an ‘even geographic spread’ as the CCG claim but, concentrated in Tiverton, Exmouth and Sidmouth, give no provision at all in the Axe Valley which is the area of East Devon furthest from the RD&E.

The closure of beds is driven by the CCG’s aim of reducing the amount of rent which it has to pay to NHS Property Services for community hospital space, and is probably a prelude to the gradual elimination of community hospitals over the next few years.

Six speakers from the affected communities will address the Committee in the Public Participation session, and I shall be addressing them as County Councillor for Seaton and Colyton.

We urge that the Committee use its legal power to refer the CCG’s decisions to the Secretary of State.

Martin Shaw
Independent East Devon Alliance County Councillor for Seaton & Colyton”

Honiton and Seaton hospitals – crunch meeting on Tuesday

Owl says: it remains to be seen whether Tory members of the scrutiny committee will be dragooned and manipulated as they were at the last meeting – when chair Sarah Randall-Johnson bent over backwards to ensure that no vote was taken on whether to refer the CCG’s decisions to the Secretary of State. The CCG had not fulfilled the criteria previously set by the committee to avoid the decision, but she insisted they should be given even more time to defend themselves

“Council [DCC] to make crucial decision on proposal to axe hospital beds
“Hospital campaigners in the Seaton and Honiton areas are preparing for a crucial meeting of Devon County Council’s health scrutiny committee next week.

Next Tuesday, Devon County Council’s scrutiny committee will decide whether to use its power to refer the decision of the NEW Devon Clinical Commission Group (CCG) to close all in-patient beds in Seaton, Honiton and Okehampton hospitals to the Secretary of State for Health.

The meeting is a defining moment in the saga surrounding the CCG’s proposals to axe all of Honiton and Seaton’s inpatient beds.

Under the initial proposals, Seaton was earmarked to retain its 18 beds – but those in Honiton and Okehampton did not appear in any of the shortlisted options following the scoring process.

A large group of protesters have now planned to congregate outside County Hall in Exeter in a last-ditch effort to reverse the proposals, before they attend the meeting at 2.15pm.

Among those who will be speaking against the plans are Seaton and Colyton county councillor Martin Shaw, Seaton mayor Jack Rowland, and the chairman of East Devon District Council’s scrutiny committee, Cllr Roger Giles. Other residents of Axminster and Honiton will also speak at the meeting.

Cllr Shaw said: “This is a crucial decision not only for the beds but also for the future of the hospitals.

“The CCG’s next step is its local estate strategy, which is likely to involve partial or even complete closures of hospitals.

“Seaton is more remote from acute hospitals than any other East Devon town and it is vital that we retain our hospital, which was built by the local community.”

Devon County Council’s scrutiny committee reviewed the proposals last month but opted to defer referring them to the Secretary of State while it investigates the health authority’s evidence for saying its ‘care at home’ policy will be better for residents.

Speaking at the meeting, Dr Sonja Manton, director of strategy at the CCG, assured the committee that they will not introduce the bed cuts until they are sure the new model of care works and she invited members to sit in on their planning for it.

If it was shown it could not be implemented, the decision to close the beds could be reversed.”

http://www.midweekherald.co.uk/news/council-to-make-crucial-decision-on-proposal-to-axe-hospital-beds-1-5113882