“Be prepared to defend hospital closures in court”

“NHS leaders looking to deliver change and transformation in their local health economy should be prepared to defend their plans in court, rather than pretending that the likelihood of legal action will never happen, Rob Webster, CEO at South West Yorkshire Partnership NHS FT, has warned.

Chairing a session entitled ‘Saving Our Services – Why are local campaigns fighting to save the NHS from transformation?’, at last week’s NHS Confed17, Webster, who is also the lead for West Yorkshire and Harrogate STP, said that even if the health service does “harness the power of communities, you can bet we will still have a fight with some people about change”.

“One of the lessons I’ve learnt,” said the former NHS Confed boss, “is so long as you have engaged with people throughout the process and have done it in the right way, and so long as you have some clinical and public voices behind the changes you want to make, and as long as you’re prepared to go to court, if and when you have to, and win, then the change will happen.

“Somebody will refer you either to the secretary of state or to a judicial review. Get ready for it, and work through it, rather than pretending it’ll never happen or thinking that if it happens it is the worst thing in the world. Get yourself ready and it will work.”

During the session, Webster asked panel members what they thought should be the priorities with regards to the STP and change agenda for the new government.

David Lock QC, former MP and legal advisor to the NHS, said: “STPs were an object lesson in how not to do public engagement.”

The idea that the NHS needed space to have honest conversations with itself before going out to the public created a huge deficit in public trust, he argued.

“The process and the constraints put on those running the process, and not to be public about what they were doing, was enormously damaging,” stated Lock. “If the ministers want to keep the STP process going on, they are going to have to do an awful lot more emphasis on bringing the public with them. In the end, you cannot deliver public services in the face of public opposition.”

Cllr Robert Smart, an advisor to the ‘Save the DGH campaign’ in Eastbourne, stated that the health secretary needs to slow down the process of the STPs “and make them into a proper 10-year strategic view”.

“And if that takes a couple of years to produce, then it takes a couple of years to produce,” he told the audience of delegates. “It isn’t a question of suddenly saying, ‘in three months’ time, we’re going to convert 40% of acute spending into community spending’.”

The following day, Jeremy Hunt admitted that, given the result of the latest general election and with the negotiations around Brexit starting just a couple of days ago, it is now unlikely that the government will be able to introduce legislation for STPs in the next few years – if at all.

Imelda Redmond, national director of Healthwatch England, also called on Hunt to “reward, and encourage, engagement with the public” on the STPs.
“It is number one on people’s agenda of what they love about the country, and what they care about,” she said. “Why would you not harness that, and get the best care we can?”

And Jeremy Taylor, CEO of National Voices, stated that the government must give the health and care system the resources it needs, and give it the time it needs to make change.

“There may be legal requirements on consultation, but there are also psychological requirements: you need time to build trust and relationships,” he reflected. “If you are doing this at breakneck speed it is just not possible to do it.”

However, NHS Improvement boss Jim Mackey also told the conference that it is possible to get “90% of the way there” with accountable care systems and accountable care organisations within the current legislative framework – “but we need to prove it”.

NHS England’s Simon Stevens later confirmed the nine areas that will officially form part of the first wave of ACSs.

Webster concluded by agreeing that time and resources are really important. “It sounds like you need to plan in the medium term and understand the money you have to do that. You could call it a sustainability and transformation partnership trying to bring everyone together,” he joked.

“I think it’s good that we have an audience that thinks it is not right to be dishonest or patronising. What we need to do is be honest and get alongside people and harness the power of communities.”

http://www.nationalhealthexecutive.com/Health-Care-News/webster-be-prepared-to-defend-transformational-change-in-court?utm_source=National+Health+Executive&utm_medium=email&utm_campaign=8412033_Newsletter+Jun+17+Week+3&dm_i=IJV%2C50ARL%2COIIF3N%2CJ36W7%2C1

Clinton Devon Estates and Budleigh Salterton “health hub” have an unhealthy relationship

Readers will recall an earlier Owl story of landowners Clinton Devon Estates grabbing a large part of the garden to Budleigh Hospital for development, considering the garden surplus to the requirements of the new “health hub” and much more suitable for their plans for two houses:

https://eastdevonwatch.org/2017/03/20/clinton-devon-estates-pitched-against-budleigh-health-hub-in-garden-olanning-battle/

The Budleigh Neighbourhood Plan designated the Hospital garden as open green space. Neighbourhood plans can do this and this space ticks all the NPPF criteria boxes. The garden was considered an essential part of the psychological and therapeutic welfare of patients at the “health hub”.

Bell Cornwell for CDE only commented at the very last minute of the very last stage. They made a number of general comments to EDDC on 16 February 2017 suggesting a loosening of a number of policy phrases and a general comment that too many green spaces were being designated. No mention of Hospital Hubs or development of that site at all.

http://eastdevon.gov.uk/media/2114156/bell-cornwell-for-clinton-devon-estates.pdf

An application to build two houses on the hospital garden was then submitted and validated on 27 February 2017 It takes about two-thirds of the garden, rather than the half suggested.

The Plan Inspector asked the steering group for clarification of criteria used in each green space case on 18 April 2017. The steering group responded, and its response was published on the internet.

The Inspector in her report sided with CDE.

The Neighbourhood Plan steering group unanimously agreed to accept all the Inspector’s recommendations except the one where she agreed with Bell Cornwell who, of course, had no medical evidence to draw on!

The decision to accept or reject Inspector’s recommendations now lies with EDDC.

The question now is – how brave will EDDC councillors they be? There is a track record of rolling over for tummy tickles when CDE engages with them. CDE has fingers in many East Devon pies and held restrictive covenants on the seafront at Exmouth that it relinquished to allow EDDC to approve the Grenadier development and has everything from large landholdings to small ransom strips all over the district.

Strong administrative pressure will be to do the easy thing and to get the plan to Cabinet in July with no controversy and no action against CDE.

Local opinion is running strongly against “droit de seigneur” ( medeival feudal rights) in this case.

If it looks like everyone is rolling over without a fight, the plan may well be rejected at referendum.

Meet and question Police and Crime Commissioner Hernandez in Exmouth

Police commissioner to attend meeting in Exmouth

The Police and Crime Commissioner for Devon and Cornwall is to answer questions from the public at an event in Exmouth.

Alison Hernandez will attend an open meeting which will take place at Exmouth Community College’s Telfer Centre on July 5, at 7pm.

Residents from Exmouth and the surrounding area will be able to question her on local issues.”

http://www.exmouthjournal.co.uk/news/police-commissioner-to-attend-meeting-in-exmouth-1-5075147

QUESTIONS SUCH AS:

Why do you need a deputy.
Why did you appoint a “good friend” to be your deputy?
Did you consult the Police and Crime Panel?
How many people did you interview for the post of deputy?
Do you really believe people with guns should supplement police?

and

What exactly are you FOR?

Oh, oh – no business rates devolution? Where’s the lost income coming from?

“Councils demand ‘clarity’ over funding after business rates devolution is dropped.

A steering group which spent the last 15 months consulting on how 100% business rates retention would work has been disbanded after the exclusion of local government finance legislation in this week’s Queen’s Speech.

Parliamentary time to consider the Local Government Finance Bill in the last Parliament ran out before Theresa May called this month’s General Election. However, the sector was stunned this week when the government made it clear that it would not revive the process for at least two years.

Room151 has seen a letter sent to members of the steering group from Anne Stuart, the newly-installed civil servant leading the business rates retention process.

It said: “I’m sorry this should be my first communication, but I am emailing because as you will have no doubt seen, the Queen’s Speech did not include a new Local Government Finance Bill and so it will not form part of the Parliamentary timetable for this session.”

In her letter, she thanked members of the steering group but said she would only be in touch “once we are in a position to resume working with you on the future of local government finance reform.”

However, she said that ministers remain committed to local government taking greater control of its income. “We are engaging ministers on the options for future reform without an immediate Bill…,” she said.

Ministers have reaffirmed their commitment to a thorough, evidence-based review and that work will continue with local government on that issue, Stuart said.

One steering group member told Room151: “This is more than a year’s work down the drain.

“If the government is planning to introduce any reform by executive order, it needs to make sure they take the sector with them.”

Lord Porter, chairman of the Local Government Association, said that the failure to move on with business rates devolution was “hugely concerning”.

He said: “While negotiating Brexit will be a huge challenge for the government, it cannot be a distraction from the challenges facing our public services. The day-to-day concerns of our communities go far beyond Brexit.

“Only with adequate funding and the right powers can local government help the government tackle the challenges facing our nation now and in the future.”

Jo Miller, Solace president and chief executive of Doncaster Metropolitan Borough Council, said: “I am disappointed that key legislation—absolutely fundamental to ensuring the future sustainability of local government—has now been dropped.

“Local government urgently needs clarity around our future funding—at present we simply face a cliff edge from 2020. This must urgently be resolved.”

A DCLG statement said: “The government is committed to delivering the manifesto pledge to help local authorities to control more of the money they raise and will work closely with local government to agree the best way to achieve this.”

The steering group to guide the process of business rates devolution was created in March last year after George Osborne announced that primary legislation would be introduced to allow councils to keep 100% of growth in business rates—up from the current 50%.”

http://www.room151.co.uk/funding/councils-demand-clarity-over-funding-after-business-rates-devolution-is-dropped/

“Spending watchdog condemns ‘risky and expensive’ Hinkley Point”

Owl says: abd still our Local Enterprise Partnership sleepwalks into disaster with OUR money.

“Generations of British consumers have been locked into a “risky and expensive” project by the UK’s subsidy deal for a new nuclear power station at Hinkley Point in Somerset, according to a damning report by the spending watchdog.

The National Audit Office said the contract sealed by ministers last September with EDF to construct the country’s first new atomic reactors in two decades would provide “uncertain strategic and economic benefits”.

Further, Brexit and Theresa May’s decision to quit an EU nuclear treaty could make the situation even worse, by triggering taxpayer compensation for EDF or a more generous deal for the French state-controlled company.

The watchdog condemned the past two governments for failing to look at alternative ways of financing the power station, such as taking a stake in the construction.

Observers labelled the report “deeply worrying”, a “strong reprimand” and a vindication of Hinkley Point C’s critics, who had argued it was too costly and advocated alternatives such as wind and solar power.

Under the terms of the 35-year contract, EDF is guaranteed a price of £92.50 per megawatt hour it generates, twice the wholesale price.

The subsidy is paid through energy bills, which the government estimates will translate to a £10 to £15 chunk of the average household bill by 2030.

At the heart of the spending watchdog’s criticism is the coalition government’s failure to look at any alternative financing model, such as taking an upfront stake in the £18bn project.

Instead, the Lib Dems and Tories decided all the construction risk for the plant must lay with EDF and its partner, Chinese state-owned CGN, to keep the project off the government’s books.

Taking a stake would have posed its own risks because of delays to projects with the same reactor design in Finland and France, the NAO admitted. “But our analysis suggests alternative approaches could have reduced the total project cost,” it added.

If the government had taken a 50% equity stake in the construction it could have almost halved the guarantee power price to as low as £48.50 per megawatt hour, according to the NAO.

The auditors were critical of ministers’ decision to negotiate bilaterally with EDF, rather than waiting for other new-build nuclear consortia to compete – an approach that the NAO noted had brought prices down on similar subsidy deals for windfarms.

The government’s case for the contract also weakened after the commercial terms of the deal were agreed by the then prime minister, David Cameron, in 2013, the watchdog said.

Delays to Hinkley and falling wholesale prices, caused by a two-year oil price slump, meant the total costs to consumers for the 35-year deal ballooned from £6bn in 2013 to £30bn now.

That number may rise even higher after new figures on power price expectations are released by the Department for Business, Energy and Industrial Strategy (BEIS) next month.

Brexit could make matters worse still, the spending watchdog warned. In January, the government said it would quit a nuclear cooperation treaty as part of the process of leaving the EU.

That withdrawal from Euratom, the NAO said, “might be interpreted as a change of law” resulting in an adjustment of the £92.50 price promised to EDF, or even trigger a one-off payment for EDF through a compensation clause in the contract.

While the NAO concluded “it will not be known for decades whether Hinkley Point C will be value for money”, the usually conservative watchdog was strongly critical of the government for not assessing alternative finance models.

However, it said the report should not be taken as a recommendation that the government takes a stake in future nuclear projects – but the idea should be explored. Such an approach has been discussed by the Japanese and UK governments for a Japanese-backed plant in Wales.

Unions, industry experts and green groups said the report showed lessons must be learned for any future nuclear subsidy deals.

Commentators also raised questions over whether Hinkley would look cheap compared with alternatives such as wind and solar, which the government had argued would cost more.

Mike Clancy, general secretary of the Prospect union, which represents nuclear workers, said: “This is a deeply worrying report that highlights the lack of accountability and leadership in British nuclear policy.”

Dr Robert Gross of Imperial College called the report a “strong reprimand” of the past two governments.

A “slavish devotion” to free markets that ruled out taking a stake and failure to wait for other nuclear projects to bring competition were to blame, he said. “Renewables will become cheap, and this was not anticipated at all. It now looks likely that by the time it is built Hinkley will seem expensive compared to new solar and wind projects.”

Nina Schrank, energy campaigner at Greenpeace UK, called the report a damning indictment of the government’s agreement. “This year’s school leavers will still be paying for Hinkley when they approach their pension age, so it is concerning that the National Audit Office is suggesting it may not be worth their money,” she said.

Jim Skea, president of the Energy Institute, which represents energy professionals, said the report held “clear messages on the steps needed to protect consumers and taxpayers in the future, including possibly radical changes to nuclear policy”.

An EDF spokesman said: “Today’s report shows that Hinkley Point C remains good value for consumers compared with alternative choices. Consumers won’t pay a penny until the power station is operating and it is EDF Energy and CGN who will take the risk and responsibility of delivering it.”

A BEIS spokesman said: “Hinkley Point C will be the first new nuclear plant in a generation. This was an important strategic decision to ensure that nuclear is part of a diverse energy mix.

“Consumers won’t pay a penny until Hinkley is built; it will provide clean, reliable electricity powering homes and creating more than 26,000 jobs and apprenticeships in the process.”

https://www.theguardian.com/uk-news/2017/jun/23/spending-watchdog-condemns-risky-expensive-hinkley-point-c-nuclear

Hernandez appoints “old friend” as her deputy

Owl says: can this woman sink any further into the swamp? How many people were interviewed for the job, one wonders. The Police and Crime Panel has to ratify the post. Now THAT will be interesting!

Crime czar Alison Hernandez has named a Conservative colleague from her local council days as her second-in-command.

The Devon and Cornwall Police and Crime Commissioner admitted in April this year that she was considering appointing a deputy commissioner to share the workload, including increased scrutiny.

She had toyed with the idea of campaigning for office alongside a running mate last year but eventually stood alone on the Tory ticket and was elected in her own right.

Now she has revealed that fellow Conservative and Torbay councillor Mark Kingscote will be her deputy.

Cllr Kingscote, a 55-year-old NHS support worker, who specialises in mental health is chairman of Torbay’s planning committee and a councillor since 2000.

He was born in Torquay and has been in the NHS for 25 years, is the elected member for Shiphay with the Willows, a ward Ms Hernandez used to jointly represent alongside him.

Devon Live first revealed the appointment earlier this month.

At the time Cllr Kingscote said he had not “had a conversation about” nor been offered the post, which carries an estimated salary level of £50,000 a year though it is expected to be part-time and cost the taxpayer closer to £30,000 annually.

However, he said he believed he had the experience to take on the role.

“I am more than capable of doing the job so I don’t see why not,” he added.

“I am chairman of the planning committee, have been on the scrutiny panel for more than four years and am perfectly capable of putting my hand to lots of different things.

“I have known Alison for a long time and we have worked together on lots of community projects in the past.

“I went down to help her last week – she said “do you want to come along?” and I said “yes”. It was quite casual, just supporting her really.

“I have been doing community engagement for a long time so it’s not unusual that I would get involved in a thing like that.

“I have been involved in diversity and supporting the police in wards I represent.”

Ms Hernandez is free to appoint a deputy, as other commissioners have, without approval from the Police and Crime Panel, which is set to convene early next month.

The commissioner’s predecessor, Conservative Tony Hogg, also took on paid help in the role.

He recruited Jan Stanhope for strategic support after he was elected, paying her around £20,000 a year for a two-day post, although she was not officially designated as his deputy.

Phillipa Davey, a Labour city councillor in Plymouth and a member of the panel which oversees the work of the commissioner, said that the appointment smacked of nepotism.

“I have to be careful what I say as at the moment I don’t know anything at all about the appointment or his credentials, she told Devon Live.

“It does seem a bit odd – jobs for people’s friends.

“I would be interested to know what experience he has and how qualified he is to do the job especially as this is a new post which we will all be paying for.”

The plans for a deputy come after the £100,000 a year chief executive of the Office of the Police and Crime Commissioner left at the end of last month.

Andrew White, who was recruited by Mr Hogg, has been hired by Lincolnshire Police to work as second-in-command to chief constable Bill Skelley.

Chief cons Skelly, who left his previous job as assistant chief constable in Devon and Cornwall last year, has hired White to become the force’s most senior civilian officer.

Ms Hernandez said she will next week ask the Police and Crime Panel to support the appointment of Mark Kingscote as her deputy.

She said he has significant experience in scrutinising the use of tax-payers money, planning, health (particularly mental health) and diversity.

“I have every confidence that Mark is the right person for this role,” she added.

“He is a strong individual who will represent the most vulnerable in our communities well, is committed to building safe, resilient and connected communities and with a track record in the areas we need to enhance efforts on.”

http://www.devonlive.com/crime-czar-appoints-old-tory-council-colleague-as-deputy/story-30406322-detail/story.html#1owjoWtiXb0PpTha.99

STPs may not be introduced till after Brexit – but are ‘Success Regimes’ similarly doomed or not?

Owl has had to resort to CAPITALS it is so mad!

OWL DOESN’T UNDERSTAND: IF STPs WON’T BE LEGISLATED FOR TILL AFTER BREXIT – WHY ARE LOCAL COMMUNITY HOSPITALS AND MATERNITY SERVICES CLOSED OR BEING CLOSED?

HONITON AND SEATON COMMUNITY HOSPITALS ARE ALREADY BEING WOUND DOWN FOR CLOSURE LATER THIS YEAR – IS HUNT SAYING THIS IS NOT LEGAL?

OUR DOCTORS AND OUR COMMUNITIES ARE AGAINST THESE PLANS, WHICH HUNT SAYS NEED LOCAL SUPPORT, SO IS OUR CCG ACTING ILLEGALLY?

TIME FOR THAT REFERRAL TO THE SECRETARY OF STATE AND A JUDICIAL REVIEW. THIS POWER-MAD, ARROGANT CCG NEEDS TO BE TAMED OR, BETTER STILL, DISSOLVED.

BUT YOU CAN BET OUR TWO MPs WON’T TOUCH THIS HOT POTATO! AND THAT MS RANDALL-JOHNSON WILL BE DEAF TO IT, AND DCC TORIES SPINELESS TOO.

THANK HEAVEN FOR PEOPLE LIKE CLAIRE WRIGHT, MARTIN SHAW AND ROGER GILES!

What Hunt said yesterday:

“Given the result of the latest general election and with the negotiations around Brexit due to start later this month, it is now unlikely that the government will be able to introduce legislation for sustainability and transformation plans (STPs) in the next few years – if at all.

Speaking at NHS Confederation yesterday, health secretary Jeremy Hunt argued that the legislative landscape has changed after a hung Parliament was declared last week. Because of this, it is unrealistic to expect the government to enact legislative health changes before the Brexit process is finished.

“We said [in our manifesto] that we would legislate to give STPs a statutory underpinning if that was felt to be necessary,” he said. “To be clear, we’re expecting to be in power until 2022 and deliver a stable government to make that possible.

“But obviously, the legislative landscape has changed, and that means that legislation of this nature is only going to be possible if there is a consensus across all political parties that it’s necessary. I don’t think that is in any way impossible, but it’s realistically not something we would do while the Brexit process was carrying on.”

Post-Brexit, he added, the government will have “a lot better understanding” of the legislative changes required by STPs. But even then, changing the law would require cross-party support – a much greater challenge now that the Conservatives no longer hold the majority in the House of Commons.

Responding to audience questions after his keynote speech, Hunt – who survived Theresa May’s recent political reshuffle – also hinted that the NHS could be in line to receive some more transformation funding.

Asked by a West Hampshire GP about the possibility of supporting transformation with ringfenced investment in order to enable new models of care elsewhere in the country, the health secretary argued “that is what the STP plans are about”.

But the biggest risk to pouring in more capital funding, he noted, is “if we don’t maintain the financial rigour and discipline that we started to see coming back into the system in the last year”.

“That was really what slowed down this process in the 2015-16 financial year, when we would’ve liked to put a lot more money into transformation,” the health secretary said. “But I think now we’re in a much, much better position to do that. We absolutely want to make sure that money is not an impediment to the rolling out of the STPs, because they are central to our vision.”

In fact, the recent NHS response to the horrific terrorist attack in Manchester, which saw staff working around the clock to cope with the unexpected demand, is a “very good reason for exactly what we’re trying to achieve with the STP process”, Hunt argued.

“The interesting lesson for me about the response in Manchester was how joined-up it was as a result of the terrific progress, under Jon Rouse’s leadership, that trusts have made in coming together as part of their STP,” he added. “I think they’ve probably gone further and faster than anywhere else in the country. I know it’s not been easy to do that, but it was extremely streamlined and effective.”

He also suggested that the government would be prepared to boost the region’s cash pot “if there are specific aspects of the response to those terrible events where there have been unexpected costs that the NHS incurred that wouldn’t be part of its normal response to emergency situations”.

STPs need local support
Asked by another audience member to explain the importance of bringing all local communities together into designing and delivering change, Hunt emphasised that the reasoning behind STPs is to bring about “fantastically beneficial” changes for patients.

“It’s a transformation that is wholly positive for the public,” the secretary of state said. “But people are passionate about their NHS and they obviously worry about any change that happens, and that’s why we have a responsibility to communicate that change. And that change is usually best not communicated by politicians, but by clinicians, because frankly you guys are trusted a lot more than we are.

“That’s why I think it’s really important to have that local engagement, and that’s why, when it comes to the big transformation plans, Simon Stevens and I are supporting them with every fibre in our bodies at a national level.
“But at a local level, we need you to be making the arguments. The evidence is that when you do that, even with potentially controversial changes, it’s quite possible to win the case to do them. But it does involve a lot of local engagement and I think that’s going to be one of the central challenges for the next few years.”

http://www.nationalhealthexecutive.com/Health-Care-News/election-result-means-stp-legislation-now-due-only-after-brexit#.WUvMkaIufac.email