£20K Calderdale Commission on health and social care meets next week to decide what it’s doing

The first meeting of Calderdale Council’s People’s Commission on health and social care is on 29th July, 1.30- 3.30pm at Halifax Town Hall.

Calderdale Council is holding its “People’s Commission” in order to:

“lead an open consultation about future health and social care provision in Calderdale and Greater Huddersfield.”

But it starts out by holding its first meeting at a time when no working people will be able to attend, and without much clarity about what its controversial Chair’s terms of reference are.

Members of the public have made many complaints that the NHS organisations held their recent “engagement” events about the “Right Care” proposals for changing the NHS and social care, during working hours. This made it impossible for people with jobs to attend.  So why is the Council repeating this mistake?

The Agenda for the first meeting of Calderdale Council’s Commission on health and social care is:

  1. Introductions
  2. Confirm Terms of Reference
  3. Background to Peoples Commission
  4. Project Plan
    • Timeline
    • Community Engagement
    • Organisational Engagement
    • Evidence Gathering
    • Themes for Future Meetings
  5. Social Care Current Models and Future Aspirations (Bev Maybury, Calderdale Council Director of Adults Health and Social Care)
  6. Existing Data Sources
  7. Any Other Business
  8. Date of Next Meeting – Wednesday 13th August at 1.30pm

Here are the papers for the Calderdale Commission health and social care meeting.

The deadline for the public to submit evidence to the Commission is 1st August.

Photo credit:Roger O'Doherty (Creative Commons sharealike non commercial attribution licence 3.0)

Beating about the bush

In order to try and find out what Calderdale Commission’s remit is, I asked the Council these questions:

1) Have the terms of reference for both the People’s Commission and the People’s Commission Chair been agreed yet? (Last time I contacted the Council, they hadn’t been agreed.)
2) If so, what are they?
3) What national evidence on health and social care will the People’s Commission review?
4) How will the People’s Commission review the clinical evidence for the proposed NHS reconfiguration in Calderdale? Given that:
 a) Calderdale CCG’s Chief Executive Dr Matt Walsh is on record as saying that the Strategic Outline Case omits clinical evidence, and 
 b) the NHS providers’ Outline Business Case, which should provide clinical evidence for the proposed service changes, is a commercially confidential document that no organisations apart from the CCGs will have access to, nor will members of the public
5) Which organisations and individuals will be called to give evidence at the select committee-type session?
6) Will they submit written testimony in advance?

This is Calderdale Council’s Press office answer:

‘Although you have asked a number of questions, we have responded with a single statement because it’s difficult to give firm details prior to the People’s Commission meeting taking place.

Calderdale Council’s Leader, Cllr Tim Swift, said:

“Many of these detailed points will be considered at the Calderdale Council’s People’s Commission’s first public meeting on Tuesday 29 July at Halifax Town Hall. At the meeting the panel will set the work programme for the People’s Commission, and that will include discussing the terms of reference; what national evidence the Commission will review; and how the process of taking the views of individuals and organisations will work.

“We want as many organisations and individuals as possible to offer evidence, in whatever form they choose. We intend this process to be as thorough and inclusive as possible.

“That’s why the panel is keen to hear from local people about their experiences of using health and social care services, and how they would like to receive services in future. They can contact us by:

Writing to People’s Commission, Town Hall, Crossley Street, Halifax, HX1 1UJ
Emailing peoplescommission@calderdale.gov.uk
Or via Twitter at @Calderdale using the hashtag #HealthyViews

“We will use people’s feedback to help shape our recommendations to the CCG.” ’

Update – turns out the Commission’s remit was drafted on 23 June

However, since Plain Speaker published this article, it turns out from Commission papers now posted on the Calderdale Council website that the (very general) Terms of Reference were drafted on 23 June, as follows:

  • To engage in public debate to understand the needs and aspirations of Calderdale residents in relation to the future shape of health and social care services in the Borough, in particular the balance between local services and specialist services.
  • To explore policy and delivery models relating to health and social care to understand ‘what works’  and is likely to produce the best outcomes.
  • To examine current delivery models for health and social care services in Calderdale and to assess where they differ from public aspiration and those models that seem likely to produce the best health outcomes.
  • To understand the Outline Business Case for change and how this will support delivering improved outcomes.
  • To develop recommendations for the future design of health and social care services, including recommendations on the configuration of hospital based provision.

Not a People’s Commission – a Council initiative

Recently Plain Speaker has heard that some people think Calderdale Commission is like the Lewisham People’s Commission It isn’t.

It seems important to be clear about what the Calderdale Commission is, and to disabuse anyone who might be expecting it to work like the Lewisham People’s Commission

On behalf of the People of Lewisham, Save Lewisham Hospital Campaign initiated and promoted the Lewisham People’s Commission into the Proposals to Close Lewisham Hospital A&E, Maternity and Children’s Services.

Lewisham People’s Commission Chair Michael Mansfield QC sums up at the end of the Commission inquiry

Calderdale Council has initiated and promoted Calderdale “People’s Commission” on health and social care, with no input from the various groups campaigning to Save Calderdale and Huddersfield Hospitals/ A&Es/NHS.

Lack of clarity about what the Calderdale Commission will review

Save Lewisham Hospital Campaign set up Lewisham People’s Commission in order to review the Secretary of State’s decision to close all major services at Lewisham Hospital, and to review the context for this decision – the fundamental changes made to the NHS over the last 30 years, since the Thatcher government introduced outsourcing/privatisation and the “internal market”.

The initial proposal for the Calderdale Commission, which the Cabinet approved, called upon the Hospitals Trust, Locala and the mental health trust to provide,

“as a matter of urgency…detailed proposals relating to extended opening hours of GP surgeries, the future development of Todmorden Health Centre, and other proposals resulting from the Strategic Review of the health and social care economy.”

It’s unclear whether these organisations will give this information to the Calderdale Commission, particularly since they have refused to take any notice of the Council’s call for them to withdraw their Strategic Outline Case for changes to NHS and social care.

It’s also not clear how the Calderdale Commission will manage to “understand” the Outline Business Case, since, on grounds of commercial interests, the Hospitals Trust has just refused a Freedom of Information request for a copy of the Outline Business Case.

And Calderdale Commission’s question about “how this will support delivering improved outcomes” seems to be prejudging the Outline Business Case somewhat.Wouldn’t it be more open-minded to ask “whether” the commercially confidential Outline Business Case would help to improve outcomes?

And what outcomes are they talking about? Money or patient care?

It’s seems that Calderdale Commission will not review the context for the Strategic Review of NHS and social care in Calderdale and Huddersfield. This would include, for example:

  • the 2010 Nicholson efficiency savings that have required the NHS to hand back £2bn/year to the Treasury – a massive NHS funding cut
  • the Health and Social Care Act 2012 which came into effect last year and is designed to lead to swift and stealthy privatisation and fragmentation of the NHS
  • the promotion of the American Kaiser Permanente model of health care as the template for NHS and social care service changes across the country, including Calderdale and Huddersfield

The Steering Group of the Save Lewisham Hospital Campaign agreed the Commission’s Terms of Reference, as follows:

“The Commission will examine:

1a. The original vision and principles underpinning the NHS, with particular reference to the community it serves and its accountability to that community.
1b. The extent to which the  vision and principles have been eroded by the imposition of the internal market and recent moves to open the NHS to external market forces, and the degree to which these changes have been openly debated
2. The extent to which this process has culminated in the potential destruction of quality healthcare for the community of Lewisham and South East London, exemplified by the proposals for Lewisham Hospital.”

Calderdale Commission’s Panel is made up of players in the NHS and social care system, not independent people

The Lewisham People’s Commission Panel was independent and consisted of:

  • Michael Mansfield, QC (Chair)
  • Professor Blake Morrison, author, poet, journalist and South East London resident
  • Baroness Warnock, academic and author of major reports on medical ethics and children with special educational needs.

Calderdale Council’s People’s Commission is chaired by a pro-privatisation academic from Oxford Brookes University, with a track record in training and advising local authorities in how to privatise their social care services.

Its members are Calderdale Councillors.

But Calderdale Council is not a disinterested party in this Commission. As well as its responsibilities for social care, the Council is now also responsible for commissioning a variety of NHS services, since the Health and Social Care Act 2012 transferred responsibility for public health to local authorities.

The Calderdale and Huddersfield Hospitals Trust’s Five Year Strategic Plan 2014-19 states that Calderdale and Kirklees Councils have said that they plan to regularly “test the market” for services they commission, such as Sexual Health Services and School Nursing.

“Testing the market” means putting services that the Hospitals Trust currently provides, out to competitive tender. The Trust’s Strategic Five Year Plan 2014-19 says that the Councils have explained that regularly putting CHFT public health services out to competitive tender will allow them to demonstrate value for money on a regular basis.

This idea of value for money ignores the high costs of competitive tendering to both commissioners and providers, and it also ignores the massive longer term costs of fragmenting and privatising NHS services.  This should surely be something any Commission on health and social care should review, but given the Council’s predisposition towards competitive tendering, it seems very unlikely that it will review this.

The members of the Calderdale Commission are:

  • Councillor Janet Battye
  • Councillor Mrs Geraldine Carter
  • Councillor Marilyn Greenwood
  • Councillor John Hardy
  • Councillor Bob Metcalfe
  • Councillor Tim Swift
  • Councillor Simon Young

The thing that most worries me about the Calderdale Commission is that the Council’s Chief Executive seems to be pushing this toothless wonder as an alternative to a Scrutiny Panel inquiry into the Right Care proposals. The Scrutiny Panel has the power to require all the NHS organisations to give evidence about what they’re doing, and to stop them if it turns out that they are in any way breaching the requirements that NHS organisations must meet when carrying out major service changes.

Plain Speaker doesn’t understand what Calderdale Commission on health and social care is trying to achieve and will not be submitting any evidence since it has no confidence that the Commission will make good use of it – or of the £20K Council funding that the Commission’s costing.

Of course, Calderdale Council and anyone else has a right of reply to this article. Please contact Plain Speaker if you would like to exercise this right.

Updated 23rd July with information from Commission papers that were posted online after the first version of this article was published.

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