LEP conflicts of interest – Heart of the South West LEP’s striking similarity to censured Greater Cambridge/Greater Peterborough LEP

This is our LEP board:

Many of them have interests in the nuclear industry, housing and commercial development, procurement and recruitment allied to many of our LEP’s investment choices.

The Chairman of our LEP is Steve Hindley, Chairman Midas Group Limited.

Just one headline from many
“Midas to deliver new National College for Nuclear in Somerset”

This is what the Public Accounts Committee had to say about conflicts of interest at Peterborough LEP:

“… the Chief Executive of Cambridgeshire County Council and Peterborough City Council, told us that she had been concerned because the conflicts of interest policy “needed to be more detailed.”

In her written evidence, she stated that the conflicts of interest policy “did not include other interests such as land, property and investment interests of board members.” …

… We asked the former GCGP LEP Chair repeatedly about his own potential conflict of interest, concerning his construction company having the contract to build on a site, while the LEP was advising on what infrastructure should be on that site. Mr Reeve refused to discuss the matter. …

… We pressed Mr Reeve specifically on when his construction company had signed the contract and when he became aware of the potential conflict of interest. We found it hard to understand how there could not be a conflict of interest if his construction company was building a site on which the LEP, of which he was Chair at the time, was putting in funds to the infrastructure, which was presumably increasing the value of the site. Mr Reeve would not provide us with any dates. We pointed out that Mr Reeve’s attitude to openness was not in keeping with the Nolan principles for holders of public office and that people in the local area are entitled to know the answer to when his company signed the contract. Mr Reeve commented “It is a private matter, it is not relevant and there was no conflict of interest.” We do not agree that it is a private matter.


And here is a National Audit Office report which came to similar conclusions:


“Tories oversee 272% rise in removing essential home care funding for Parkinson’s and Alzheimer’s sufferers”

“An investigation has revealed that thousands of chronically ill and disabled people are having NHS funding for their care removed, leaving their families to pick up enormous bills. And proposed ‘efficiency savings’ are likely to make the situation much worse.

The problem is with people who have been granted NHS Continuing Healthcare (CHC) funding, which pays for care outside hospital for people who are found to have a ‘primary health need’. If their need is considered ‘social’ rather than medical, they get no help with paying for care costs or nursing home fees – a criteria which is seemingly becoming harder and harder to meet, even for people with the most serious conditions. With nursing home fees averaging over £40,000 a year, whether or not someone is deemed eligible for the payment is obviously a crucial issue.

The investigation for This is Money found that between 2013 and 2016, the number of people having their CHC payment removed rose by a staggering 272%, from 593 to 2,211 people. These include people with long-term, deteriorating conditions such as Alzheimer’s and Parkinson’s disease, who have suddenly been told they are no longer eligible despite their condition being unchanged or worsening.

And whilst these numbers may sound relatively small, NHS England is demanding ‘efficiency’ savings from CHC of £855m by 2020/21, leading to concerns that many more people are going to have their funding cut off.

Making decisions about who is eligible for CHC is the responsibility of Clinical Commissioning Groups (CCGs), defined as ‘clinically-led statutory NHS bodies responsible for the planning and commissioning of health care services for their local area’. The vast number of CCGs – 207 in England – and their differing interpretations of CHC criteria mean that whether you are granted funding may depend as much on where you live, as what your health needs are.

A January 2018 report for the Public Accounts Committee noted that there is a huge variation in the numbers of people granted CHC funding across CCGs, ranging from 28 up to 356 people per 50,000 population.

The stakeholders representing patients raised concerns that CCGs are increasingly placing arbitrary financial caps on the cost of care packages and may be forcing people to accept lower cost packages that do not meet their care needs.

But speaking to the Public Accounts Committee, Simon Stevens, Chief Executive of NHS England, was adamant that people granted the payment would not see their care affected by the cuts. MP Nigel Mills asked him:

So there is absolutely no pressure on CCGs from you or the Department to find ways of rationing this care or reducing its quality? We want people to get the right care for their needs in the right setting; is that what we are aiming for?
To which Simon Stevens replied: “We are aiming for that.”

But there’s already evidence of rationing. One of the witnesses at the PAC hearing was Brian O’Shea, the Continuing Healthcare Adviser at the Spinal Injuries Association. He talked about a 53 year old man with a spinal injury, with four young children, who has been in hospital for six months. He has been told that he’ll have to go into a nursing home, as the care costs of supporting him in his family home are too great. O’Shea said:

What they are doing is using it [CHC] as a tool to blackmail people into accepting unsafe levels of care and of funding to live in their own home or their preferred setting of care and relying on informal support to pick up the rest of the care.

So despite what Simon Stevens says, it’s hard to see how £855m in ‘efficiency savings’ can be made without refusing the payment to many people who should be eligible, or reducing the package of care people are granted.

It’s clear the problem is already there, and these cuts can only make it worse. As ever with the Tories’ entirely discredited regime of systematic cuts to vital public services, it’s the most vulnerable who will suffer.”


“Accountable Care” – if it walks like a duck …

BMA website link:
What are Accountable Care Organisations (ACOs)?

An ACO brings together a number of providers to take responsibility for the cost and quality of care for a defined population within an agreed budget.

The key feature of an ACO is that there will be a single contract with a single organisation for the majority of health and care services in the area.

The ACO contract holder would be responsible for the provision of services, but may not necessarily deliver all the services itself; it could instead hold sub-contracts with other providers.

This is our artistic impression.