29 Sep 2011

Strong cross-party call for scrutiny of NHS by our County Council

Well last night at an Extraordinary Stroud District Council meeting we discussed a motion calling for proper scrutiny of the changes in the NHS to set up a social enterprise. First that then the Judicial Review, more about the debate plus some of the press coverage.....a bit of a long blog this morning and rather hasty - hope it makes sense!

Photo: from Matt Archibald - see his collection from march here.

It was a Green Party and Labour Party motion that in the hurry was, in my view, not worded as best as it could have been -  I suspect also there was not an understanding of the strong cross-party concerns about the changes to the NHS and the lack of scrutiny around those changes.

Anyhow it was a couple of hours of not very impressive democracy - virtually no one seemed able to defend the social enterprise - a couple of Tories made some noises but it seemed clear that all were happy to see more scrutiny of the changes. However in attempts to water down the language of the motion the Tories put forward an amendment that made no sense. I called for the solicitor to rule on it but amazingly it was legal - it therefore meant the Tories had to put another amendment to improve it - sadly this also made little sense!!!!! By this time we were all getting a little frustrated....

Anyhow other attempts at amendments were made then a Tory, Gordon Craig made a bold move...he only made very slight changes to the original amendment that retained the key line: "We demand proper scrutiny by the Health Community and Care Scrutiny Committee so that assumptions being made can be tested and alternative proposals can be considered."

This got through unanimously - well done Gordon. With a unanimous result it will have much more impact on Steve Macmillan (chair of the health scrutiny) than if we had won on a narrow vote. However Gordon was very wrong when he claimed that our NHS was not efficient - see report here.

Judicial Review?

Anyway a quick aside - my video of the Stroud Against The Cuts 'Save Our NHS' march can be seen at: http://youtu.be/g7s0vTzuNeA You can also see more re the Judicial Review here.
Cllr John Marjoram and Caroline Molloy of Stroud Against the Cuts have now had discussions with the solicitors. The current state of play is that the transfer of 3000 Primary Care Trust staff out of the NHS and into what would be the largest "Community Interest Company" in the country is off whilst NHS Gloucestershire management assesses their legal position.

In the mean time I understand that NHS Gloucestershire has given us an absolute guarantee that they won't transfer anyone or anything out of the NHS without giving us 3 clear days notice. Whilst we still hope they will see sense and halt a process no-one wants, if or when they do give such notice, the claimant intends to lodge a formal Judicial Review application, which will be backed by any necessary injunctions to halt the transfer.

I understand we have had legal opinion that we have a good case that they cannot just quietly hand thousands of health workers out of the NHS and over to a handpicked private limited company. 

Green Party leader Caroline Lucas has joined the debate - she said to the Glos press: "By drafting in private companies to deliver essential healthcare, the county risks undermining the very principles on which the NHS is built."

Keep checking the Stroud Against The Cuts website for the latest on the transfer and the legal situation. Finally a fighting fund has been established - for although we have obtained Legal Aid, the initial cost to get Michael Lloyd’s case into the  into the Courts will be in the region of £5000 plus. If we win the case we will get the money back. Please send cheques to John Marjoram, saying if you want your money returned if we win. Then he will pass on to the treasurer. Send to 8, Castle St Stroud, Glos GL5 2HP cheques to read, “Keep Gloucestershire’s NHS public”.

Last nights debate

One issue I was very disappointed that was not answered by the Tories was around why we have got to this place with no scrutiny of the changes. Legislation requires our County Council to ensure that its' scrutiny committee has the power to scrutinise the planning, provision and operation of health services. They have these powers.

Yet it appears that despite the most significant changes ever to our NHS, they have not used these powers. Cllr Stephen McMillan, Chair of that Scrutiny committee, replied to my concerns in a letter stating that since September 2010 the County Scrutiny committee has been sent reports  about the development of the social enterprise but that they only discussed the matter at a meeting in September this year. 

Well that September meeting was only due to public uproar. And when they discussed it, they appear to only have spoken to the Chief Execs in charge of pushing through the changes. Where was the chance for an alternative view? One person likened this to a judge disallowing any evidence from the defence then inviting the jury who are all in his or her pocket to reach a decision.

Indeed in my first meeting in our Strategic Overview and Scrutiny Committee in June I also raised serious concerns as this Council had not received a report from our representative on the County Scrutiny committee regarding the changes. I have since learnt that out of 7 previous Scrutiny meetings we have only had reports at three - I wasn't on that Committee then but it seems those did not cover the changes.

So I still don't know why our County scrutiny committee failed to scrutinise. Next week we have a scrutiny meeting at which I hope to raise the issue again to see if some light can be shed.  I've also written again to Cllr Stephen McMillan.

Surrey example

I have already noted the very recent case of Central Surrey Health - this has been the official flag bearer for social enterprise in health. Frances Maude and David Cameron gave them the first ever Big Society award last November. We have just seen Central Surrey Health attempt to win a competitively tendered NHS contract. They failed. The £500m contract went to a private company. Many are now wondering if Surrey Health can retain it's core business. If this award winner can't what hope is there for others?

Does this not add weight to those who are suspicious that the government plans to break up the NHS and allow private corporations in through the backdoor?

We have also seen news in the last week or so that patient care is under threat at more than 60 NHS hospitals which are “on the brink of financial collapse” because of costly private finance initiative schemes (see here). Companies who run such PFI schemes boast profit margins of up to 71 per cent on the projects! Privatisation is just not good for our health service.....OK that was an understatement....

Anyway click on read more to see some of the questions we want the County Scrutiny to consider and some of the press links. Another blog tomorrow on other items from the Council meeting but now I need coffee and must get to work....

The following questions need to be answered before any decision is taken:
• What are the alternative possible structures and why is a social enterprise
outside of the NHS considered the most suitable?
• Who will actually own the company? Who appoints the Board? Who appoints the
Chief Executive? How will staff actually be involved in the running of the company
and the appointment of future managers?
• What will be the terms and conditions for existing staff if or when they move to
this organisation?
• What assurances are there if the social enterprise fails?
• What will be the terms of conditions for new staff?
• Will staff who transfer from the social enterprise back to the NHS loose out on
pensions compared to those who remain in the NHS throughout?
• How will the local community be represented and what degree of control
will community representatives have?”

Some of the previous press stories:

Stroud Life: OAP leading fight to halt NHS handover

The Citizen: Hundreds march to protect NHS in Gloucestershire - http://www.thisisgloucestershire.co.uk/Hundreds-march-protect-NHS-Gloucestershire/story-13404685-detail/story.html

BBC Gloucestershire: Judicial review threat to NHS Gloucestershire

1 comment:

Anonymous said...


See full info at:

Just a few days ago, the BMA (British Medical Association) again
called for the bill to be scrapped, stating their fears that many of
the UK's hospitals would close under the new laws.

The government would effectively lose responsibility for providing a
universal health service.
A recent study in the Journal of the Royal Society of Medicine showed
that the NHS is the most efficient health service in the world in
terms of lives saved per pound. But performance doesn't matter
when a heady mix of money-making potential and neo-con ideology rules.
'The NHS is a sixty year mistake' said tory MEP Daniel
Hannan, speaking on Fox News in 2009. In the same year MP Oliver
Letwin warned: 'The NHS will not exist within five years of a
Conservative victory'.

That's not to say that the NHS could continue on its merry way
as it currently stands given our semi-bust financial position:
something had to give. We have a growing, ageing population, absorbing
environmental health-harming chemicals over the course of several
decades, and selfishly staying alive longer with the help of newly
developed expensive drugs. Therefore the demand for - and the cost of
- the NHS has risen exponentially.

It's with the NHS is under such pressure, these changes
couldn't come at a worse time. The abolition of the current
service commissioning bodies, Primary Care Trusts, which the
government portrays as useless bureaucracy - will actually
rid the organisation of experienced managers at the time when the
whole system is being pushed at breakneck speed into total
organisational chaos. Chaos might be desirable at a punk gig, but not
in a hospital. If the reforms are bulldozed through, there's a
real risk of big care failures.

And even if, by magic, the transition to G.P-led commissioning was as
smooth as a pre-surgery shave, then the savings probably
wouldn't match the hype. Because most G.Ps have no interest in
being part of commissioning 'consortia' (even though the
word makes them sound all important, like), so it's private
companies waiting in the wings to lap up the taxpayer dosh to provide
the admin/manegerial support stuff they don't want to do.

Tory health minister Andrew Lansley's answer to the cost
conundrum, a continuation of Blair and Major before him, is that
competition - in the form of outsourcing to the private sector -
will make all service providers push down costs as much as possible,
so the whole 'universal health care' ideal will be