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:

Getting those winter performance figures that Randall-Johnson was happy to wait months for:

Social care not working:

Ambulance service under intense pressure due to cost-cutting:

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


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

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.


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.


“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.”

“Social care postcode gap widens for older people”: EDDC tries to claw back its mistakes too late

Last week, desperate Tories put a much-too-little! much-too-late motion to East Devon District Council:

“To ask the Leader of East Devon District Council to request Sarah Wollaston, Chair of the Parliamentary Health Select Committee, to investigate the effects on Rural Communities of the STP actions and to test if Rural Proofing Policies have been correctly applied to these decisions in order to protect these communities”


As Owl noted at the time, this is somewhat rich, as their Leader, Paul Diviani, voted at Devon County Council AGAINST sending the document to the Secretary of State for Health (where this could have been highlighted in the covering submission) against the instructions of his EDDC Tory Councillors and never having consulted other Devon Tory councils he was supposed to represent. He was ably assisted in this by former EDDC Chairman Sarah Randall Johnson, who as Chair of the DCC committee, railroaded their choice of action by effectively silencing any opposition (EDW passim)

This led to the accelerated closure of community beds in Honiton and Seaton, following on from earlier closures in Axminster and Ottery St Mary.

A subsequent vote of “No Confidence” in Diviani at EDDC (brought by non-Tory councillors) was defeated by the very Tory councillors he had defied!

Now we read that “Social care postcode gap widens for older people” and that social care is breaking down in deprived areas – many of which are inevitably rural.

… The knock-on effects for the NHS see elderly patients end up in hospital unnecessarily after accidents at home, while they cannot be discharged unless they have adequate community care in place. Among men, 30% in the poorest third of households needed help with an activity of daily living (ADL), compared with 14% in the highest income group. Among women, the need for such help was 30% among the poorest third and 20% in the highest third.

There is a growing army of unpaid helpers, such as family and friends, propping up the system. Around two-thirds of adults aged 65 and over, who had received help for daily activities in the past month, had only received this from unpaid helpers, the figures revealed.

Spending on adult social care by local authorities fell from £18.4bn in 2009-10 to just under £17bn in 2015-16, according to the respected King’s Fund. It represents a real-terms cut of 8%. It estimates there will be an estimated social care funding gap of £2.1bn by 2019-20.

While an extra £2bn was provided for social care over two years, a huge gap remains after the latest budget failed to address the issue. Theresa May was forced to abandon plans to ask the elderly to help pay for social care through the value of their homes, after it was blamed for contributing to her disastrous election result. The government has promised to bring forward some new proposals by the summer, but many Tory MPs and Conservative-run councils are desperate for faster action.

Ministers have dropped plans to put a cap on care costs by 2020 – a measure proposed by Sir Andrew Dilnot’s review of social care and backed by David Cameron when he was prime minister.

Izzi Seccombe, the Tory chair of the Local Government Association’s community wellbeing board, said: “Social care need is greater in more deprived areas and this, in turn, places those councils under significant financial pressures. Allowing councils to increase council tax to pay for social care, while helpful in some areas, is of limited use in poorer areas because their weaker tax base means they are less able to raise funds.

“In more deprived areas there is also likely to be a higher number of people who rely on councils to pay for their care. This, in turn, puts even more pressure on the local authority.

“If we are to bridge the inequality gap in social care, we need long-term sustainable funding for the sector. It was hugely disappointing that the chancellor found money for the NHS but nothing for adult social care in the autumn budget. We estimate adult social care faces an annual funding gap of £2.3bn by 2020.”

Simon Bottery, from the King’s Fund, said: “We know that need will be higher in the most deprived areas – people get ill earlier and have higher levels of disability, and carry that through into social care need.

“We also know that the councils that have the greater need to spend are, on average, raising less money through the precept [earmarked for funding social care].”


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]

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!”