DCC Health and Social Care “Scrutiny” – Claire Wright continues her battle

“Health and Adult Care Scrutiny Committee meeting: A PACKED AGENDA….

I asked for several items, including the future of our community hospitals, the plight of local carers, the local NHS deficit and what is being done to reduce it.

Also, on the agenda is how the local NHS coped with winter pressures (something I have asked for, for months and even resorted to a Freedom Of Information request on – it was refused, I have issued a formal complaint)……..

I have been really disappointed in recent months and years at what I see as a systemic lack of accountability in the NHS. As a Health Scrutiny Committee member, I would expect to get straight answers to straight questions at meetings, but unfortunately this rarely happens, which is why I was forced to submit a Freedom of Information request about a basic set of data tables relating to winter pressures.

I will not hesitate to do this again.

The report on carers starts on page 55 of the link below. This came about after I read a detailed survey and saw that local people who are caring for loved ones may not feel very supported.

I subsequently had a meeting with senior officers and saw the raw (anonymised) data from local focus groups. It was disturbing and it appeared to me that many local carers are having a really hard time managing, because of the government’s austerity agenda. I asked for the report to be referred to the Health Scrutiny Committee, but was told this wasn’t possible as consent had not been given by the participants of the focus group.

A version of the report has been submitted instead. I am pleased that a number of measures have been put in place by officers to try and improve matters, however, I have already told senior officers that leaving out the comments has meant that the voice of carers has been lost, in my view.

I believe that there should have been an attempt to secure retrospective consent for the publication of the report, as without a proper voice, the government will simply carry on ignoring carers’ plight – and they deserve better.

If you want to read the reports – and if you care about our NHS I would urge you to! The link is here
http://democracy.devon.gov.uk/ieListDocuments.aspx

Members of the public are permitted to address the committee in the 15 minute slot at the beginning of the meeting, but need to register four days ahead to do so. Email Gerry.rufolo@devon.gov.uk

The meeting starts at 2.15pm on Thursday 7 June. It will be webcast from this link:

https://devoncc.public-i.tv/core/portal/home

and archived afterwards.

Should Randall-Johnson remain chair of the DCC Health and Social Care Scrutiny Committee (or even be a councillor at all?)

We all know our problems with Randall-Johnson as Chair of DCC’s Health and Social Care Scrutiny Committee (or, if not, we should). Here are just a few of many Owl posts on this councillor and her behaviour as its Chair:

https://eastdevonwatch.org/2017/08/12/conduct-of-health-committee-members-investigated-by-devon-council-diviani-and-randall-johnson-heavily-criticised-for-behaviour/

https://eastdevonwatch.org/2017/06/24/claire-wrights-report-on-the-disgraceful-dcc-nhs-meeting-and-its-disgraceful-chairing-by-sarah-randall-johnson/

https://eastdevonwatch.org/2017/08/31/councillor-calls-for-randall-johnson-resignation/

NOW, it seems, she was EXTREMELY reluctant to allow the CCG’s Sustainability and Transformation Plans to be a standing item on her committee’s agenda and inly the intervention of a “committee adviser” led to this being agreed. See Claire Wright’s blog for details:

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

“… Essentially, the NHS in Devon is looking at a £500m overspend by 2020 unless major cuts and centralisation of services take place.

It is absolutely vital that the committee keeps a very close eye on what cuts are to be made and how this is affecting patients. We are their only ears and eyes on this.

When I made this proposal yesterday – that we receive a detailed report at each committee meeting. Chair, Sara Randall Johnson appeared to be reluctant to introduce such a standing item, given all the other issues that needed to be examined.

I could not see her point of view at all. Surely, this is the most important issue facing Devon’s patients today?

Committee adviser, Anthony Farnsworth suggested that councillors have sight of the CCG’s own financial reports relating to the STP on a regular basis and this was a legitimate area of scrutiny. …

This was agreed.

Here’s the webcast – https://devoncc.public-i.tv/core/portal/webcast_interactive/318671

What is this woman’s problem? Is it simply that she knee-jerks a “no” on any and every proposal from Independent Claire Wright” – putting personalities before what is best for Devon, its healthcare and its scrutiny? We know she has problems with Ms Wright’s forthright defence of our NHS against cuts and privatisation (though the problem seems to stem from further back when the then Leader of East Devon District Council was ousted from her seat by the likeable, knowledgeable and planning policies aware winning candidate – Claire Wright).

Or is it even more dangerous than that? Putting HER personal political beliefs and ideology above those of others – including moderate DCC Tory councillors – and forcing them on others by whatever means she has at her disposal?

Questions, so many questions, and so few answers.

DCC Councillor Martin Shaw (East Devon Alliance) updates on NHS changes

This is a long article but if you want to know where we are with NHS changes in Devon this gives you all the information.

Our pressure has led to Devon NHS joining a national retreat from privatising Accountable Care Organisations. However the Devon Integrated Care System will still cap care, with weak democratic control – we need time to rethink

We must thank ALL our Independent Councillors – particularly DCC Independent Councillor Claire Wright, DCC Councillor Martin Shaw (East Devon Alliance) and EDDC Councillor Cathy Gardner (East Devon Alliance) for the tremendous work they have done (and continue to do) in the face of the intransigence (and frankly, unintelligence) of sheep-like Tory councillors.

At EDDC Tory Councillors told their Leader to back retaining community hospitals, so he went to DCC and voted to close them (receiving no censure for this when Independents called for a vote of no confidence).

At the DCC, Health and Social Care Scrutiny Committee Tory members were 10-line whipped by its Chair Sarah Randall-Johnson to refuse a debate on important changes and to vote for accelerated privatisation with no checks or balances.

At DCC full council – well Tory back-benchers might just as well send in one councillor to vote since they all seem to be programmed by the same robotics company!

Our local health services: our last line of defence

From the Save Our Hospital Services Facebook site:

:… these guys are our last line of defence. They need to work harder at not being manipulated.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

If so, it will only be because they failed to find out – or scrutinise.”

Claire Wright and Martin Shaw fighting heroically for our NHS

Thank heavens we have Claire Wright and Martin Shaw fighting so hard for our NHS on a daily basis and don’t have to leave the fight to Swire, Diviani, Sarah Randall-Johnson and East Devon Tories – or there would be no fight at all!!!

Holding NHS Property Services to account:
http://www.claire-wright.org/index.php/post/nhs_property_services_and_nhs_managers_requested_to_fully_engage_over_commu

Getting those winter performance figures that Randall-Johnson was happy to wait months for:
http://www.claire-wright.org/index.php/post/new_devon_ccg_to_provide_performance_winter_pressures_reports_within_days

Social care not working:
http://www.claire-wright.org/index.php/post/latest_devon_social_care_survey_reveals_concerns_among_people_about_service

Ambulance service under intense pressure due to cost-cutting:
http://www.claire-wright.org/index.php/post/devon_county_council_health_scrutiny_committee_records_its_concerns_over_am

Decisions on community hospitals:
Health Scrutiny hears there will be no precipitate decisions on community hospitals – local conversations with CCG and RD&E offer chance to shape ‘place-based health systems’ around towns

Declining performance:
Devon’s health system’s declining performance over last 12 months – and Health Scrutiny still waiting for winter crisis evidence

DCC Councillor Claire Wright: “NHS REFUSES TO PROVIDE WINTER PRESSURES INFORMATION FOR DEVON COUNTY COUNCIL HEALTH SCRUTINY COUNCILLORS”

I am really disappointed to report that despite me asking at the beginning of January for the winter pressures information to be available at the 25 January Health and Adult Care Scrutiny meeting, it is not going to be provided.

Given the avalanche of very worrying “NHS in Crisis” press stories I sent several emails to committee chair, Sara Randall Johnson, at the beginning of January asking for information such as delayed discharges, A&E waits, levels of norovirus, staff vacancies and various other pieces of information.

I was told it would be published as part of the performance review. However, when the agenda papers were published last week, the performance review charts gave information until the end of November only.

I have since been told by the committee chair that a representative from the NEW Devon CCG claimed that they weren’t in a position to provide the information because it would give councillors an incomplete picture.
If this isn’t infuriating enough, winter pressures data is updated on a daily basis and circulated to NHS and social care managers. They have the information. And it’s as up to date as today.

The health scrutiny committee chair indicated during a phone call with me on Saturday that she thought this was acceptable and that this data not being provided until the March meeting was fine!

When I asked (as per the email below) for the data to be provided under ‘urgent items’ I was told the issue wasn’t urgent and there wasn’t time to get the paperwork out in any case.

The refusal to supply this information, is in my view, a deliberate obfuscation. An attempt to interfere with the democratic and legitimate process of scrutiny and the NHS should have been pressed to provide it for this meeting.

Here’s my email to chair, Sara Randall Johnson, sent last Wednesday (17 January):

Dear Sara

I am very disappointed that there will be no specific written report on winter pressures at next week’s meeting.

I think that most people, given that ongoing national crisis that the NHS is experiencing right now, would find it inconceivable that our committee did not have this important information to assess how our major hospitals are managing during winter.

I see that there is an agenda item for urgent items at the beginning of the meeting.

Can I ask that this information as I previously asked for, is included in the form of written reports from the four NHS acute trusts, as an urgent agenda item. This to include delayed discharges for the winter period and up until next week, A&E waits and numbers, staffing vacancies, levels of norovirus and all the other standard winter pressures reporting that the trusts do on a daily basis for their managers.

I look forward to hearing from you.
Best wishes
Claire”

Next meeting of DCC Health Scrutiny meeting: SOHS suggests action

SOHS suggests the following action following receipt of a letter from Martin Shaw Independent East Devon Alliance Cllr for Seaton and Colyton.

SOHS:

Please email the councillors on the Devon Adult Care Scrutiny Committee insisting that they discuss this and vote to stop implementation due on 1 April.

sara.randalljohnson@devon.gov.uk
nick.way@devon.gov.uk
hilary.ackland@devon.gov.uk
john.berry@devon.gov.uk
paul.crabb@devon.gov.uk
rufus.gilbert@devon.gov.uk
brian.greenslade@devon.gov.uk
ron.peart@devon.gov.uk
sylvia.russell@devon.gov.uk
philip.sanders@devon.gov.uk
richard.scott@devon.gov.uk
jeff.trail@devon.gov.uk
phil.twiss@devon.gov.uk
carol.whitton@devon.gov.uk
claire.wright@devon.gov.uk
jeremy.yabsley@devon.gov.uk
pdiviani@eastdevon.gov.uk

“Devon’s two Clinical Commissioning Groups (CCGs) are pushing ahead with far-reaching, highly controversial changes to the NHS in the County from 1st April – without alerting the public or even the public watchdog, the Health and Adult Care Scrutiny Committee at Devon County Council.

“The changes will turn the Sustainability and Transformation Plan – which itself grew out of the misnamed ‘Success Regime’ which closed our community hospital beds – into a more permanent Devon Accountable Care System. The first phase, in the first part of the financial year 2017-18, will develop integrated delivery systems, with a single ‘strategic commissioner’ for the whole county.

However the real concern is the next phase, which will lead to the establishment of Accountable Care Organisations. These will lead to services being permanently financially constrained, limiting NHS patients’ options for non-acute conditions, and pushing better-off patients even more towards private practice.

“Large chunks of our NHS will be contracted out for long periods, probably to private providers. The ‘toolkit’ for this fundamental change talks about ensuring ‘that there are alternative providers available in the event of provider failure’. In the aftermath of Carillion, do we really want most of our NHS contracted out to private firms?

“Devon’s public are not being consulted about this change – unlike in Cornwall where the Council has launched a public consultation – and there is no reason to believe that they want a privatised, two-tier health system.
“Devon’s CCGs have pushed the change through without publicity, and it is only because I have put it on the agenda that Health Scrutiny will have a chance to discuss in advance of April 1st. I have written a 7-page paper for the Committee outlining what we know about the ACS and posing eight questions which they should ask about it.”