Devon’s NHS asked to provide a range of assurances on controversial new integrated care system
Friday, 23 March 2018 0 Comments by Claire
Devon’s NHS has been asked to provide assurances over a range of issues, as well as associated documentation, before proceeding with its plans for a controversial so-called integrated care system in the county.
The brake on the process was applied at yesterday’s (Thursday 22 March) Devon County Council’s Health and Adult Care Scrutiny Committee, which also recorded its concerns at the plans, set to be put in place next month.
The new system, which is coming into force in health areas across the country, will mean a merger of the two clinical commissioning groups in Devon, at least at board level to start with, and is widely being seen by campaigners across the country, as the beginning of a break-up of the NHS – and a clear route through to more privatisation and less public accountability.
Nationally, there are legal challenges by senior medics who are convinced that the move to ‘accountable care’ as it was originally called, will be disastrous for patient care and the public functioning of the NHS.
We are repeatedly told by local NHS and social care managers that it is just about integration of health and social care and is another step on a long journey. But that is disingenuous.
This is the start of a very new style of working and no one is very clear where it will end up. What is certain though, is that it is being driven by Conservative Secretary of State for Health and Social Care, Jeremy Hunt and if he tells the NHS to move in a certain direction, they must do as he says.
So although this new system debated at Devon County Council’s Health and Adult Care Scrutiny Committee yesterday is at an early stage, its direction of travel is clear. We are heading for a more formal set up of groups of organisations and no one can reassure members of the public how the governance or funding will operate.
For example, the NHS is free at the point of use and social care is means tested. So if budgets are merged, will social care become free at the point of use? Highly unlikely. So what does this mean for NHS care?
At yesterday’s Health and Adult Care Scrutiny Committee meeting, very well informed and articulate members of the public from the Devon Save Our Hospital campaign group addressed councillors, as well as Cllr Martin Shaw. Also, Cllr Julian Brazil (speaking on behalf of the LibDem group) who are very concerned about the plans.
Cllr Martin Shaw (Seaton Independent) was successful in getting the health scrutiny committee to take on this issue earlier this year and is incredibly well researched and informed on the issue.
Feelings and anxieties were running high during the meeting. Some speakers were heckled by members of the public, which prompted chair, Sara Randall Johnson threaten several times to throw them out.
Committee members had received dozens of emails from members of the public who wanted councillors to object to the plans.
Most of the committee fortunately, seemed concerned. I made the following proposal, which was agreed unanimously.
The section in brackets was very disappointingly, deleted by the Conservatives on the committee, despite the NHS representatives agreeing to a period of public engagement . This is a great shame, but I remain pleased that the rest of my recommendations were supported.
(a) record the Committee’s concerns over the emerging Devon Integrated Care System being a single Integrated Strategic Commissioner, a number of Local Care Partnerships, Mental Health Care Partnership and shared NHS corporate services;
(b) defer the implementation of the Integrated Care System process until assurances are provided on governance, funding, the future of social care from a democratic perspective (and when a full engagement process has taken place - the part on public engagement was deleted by the Conservatives unfortunately);
(c) recommend Councillor Ackland’s paper and proposals on the reformation of the Health and Wellbeing Board as a sound democratic way forward to provide the necessary governance on a new integrated system;
(d) give assurance that the proposals will not lead to deeper cuts in any part of Devon as a result of the ‘equalisation of funding’;
(e) provide a copy of the business plan being developed and a summary of views from staff consultations.
Cabinet will now need to consider these recommendations.
If you wish to watch the debate, here’s a link to the itemised webcast - https://devoncc.public-i.tv/core/portal/webcast_interactive/318671
Pic: Standing room only. Yesterday’s Health and Adult Care Scrutiny Committee meeting.