NHS commissioners hoodwink Council Scrutiny Panel over setting up Care Closer to Home without public consultation

Yesterday Calderdale Adults Health and Social Care Scrutiny Panel members failed to use their power to decide whether the Calderdale NHS Commissioners need to consult the public about the new community health care system they are in the process of setting up.

Instead they have given the nod to the CCG to go ahead with their plans and report back to the Scrutiny Panel later.

Members of the public said they had now lost faith in the Scrutiny Panel’s ability or willingness to use its powers to protect the NHS in Calderdale.

One member of the public said,

“They might as well have been saying rhubarb rhubarb for two hours, for all the use that meeting was.”

Last month Calderdale Clinical Commissioning Group – the organisation that decides what health services to buy and which organisations to buy them from  – made a decision against the Councillors’ wishes, to go ahead and set up a new community health care system in Calderdale without any public consultation.

Yesterday the Scrutiny Panel let the CCG justify their decision to postpone public consultation, without requiring them to provide convincing evidence that this is the right course of action.

But it is in the Scrutiny Panel’s power to make the judgement about when changes to NHS services amount to a significant variation that requires public consultation.

Calderdale CCG Chief Officer Dr Matt Walsh reminded the Scrutiny Panel of this when he said,

“We are not going to formally consult unless you tell us we are making a significant change.”

Instead, the Scrutiny Panel tacitly accepted the CCG’s claim that Phase 1 of the new community health system, which the CCG aim to implement by the end of this year, would not significantly change existing NHS services, despite attempts by Cllr Metcalfe and Cllr Shoukat to challenge this.

And despite recently agreeing to act on a public petition calling for the Scrutiny Panel to formally inquire into the Calderdale NHS shake up plans known as Right Care Right Time Right Place, and to allow the public to ask questions in this inquiry, the Scrutiny Panel chair didn’t ask the CCG any questions that the public had sent in before the meeting, or allow the public to ask any questions in the meeting either.

But it has been members of the public who have dug out useful information at Calderdale Council People’s Commission meetings.

Personally I am now well fed up with reporting on the slithery CCG

And I expect you are fed up with reading these reports.

But here it is, bearing witness to the fact that these events occurred.

Why is the CCG keen to hold off consulting us about what we think of what they want to do to the NHS in Calderdale?

I wonder.

The CCG’s Care Closer to Home commissioning intentions Report completely contradicts itself about the reasons for delaying public consultation.

On the one hand, it says that the CCG doesn’t want to hold a public consultation this year, as originally planned, because (p8):

“The absence of a direct understanding of the improvements that the new community model would bring, means that the consultation is likely to be focussed on changes to hospital services.”

On the other hand, the Report repeatedly claims that the public engagement has shown strong support for the Care Closer to Home proposals, and they give the public what they’ve told the CCG they want.

This is like the Ugly Sisters trying to force the glass slipper first onto one foot, then the other. Neither fits.

Is either statement true?

Both statements cannot be true. But is even one of them true?

Is it true that that the public lacks “direct understanding of the improvements the new community model would bring”?

Or is it true that the CCG has developed the Care Closer to Home proposals in order to give the public what they’ve said they want?

Or is neither of them true?

No Councillor asked these basic questions.

Nor did they ask why it would be a problem for the consultation to focus on changes to hospital services.

But the obvious inference is that the CCG doesn’t want a consultation this year that would focus on changes to hospital services, because it knows the public would say a big fat No.

This was the elephant in the room at the Scrutiny Panel meeting

Dr Brook, the Chair of the CCG Governing Body, avoided it by claiming,

“People are too dependent on hospitals and would be better off with Care Closer To Home. We need to set up Care Closer To Home before consulting about hospital services.

Care Closer To Home doesn’t pre-empt what changes can happen to hospital services.

The danger of doing the consultation prematurely is that we would have to change hospital services without having changed community services.”

But this “danger” is far from self-evident. The consultation could perfectly well be about changing community services first and then cutting hospital services.

Dr Brook whined,

“It’s not been a completely easy path to take. There has been urgency from the hospital. It’s been a tough call to make.”

If you still have the stomach for a more verbatim account of who said what,  here is a pretty blow-by-blow report that covers:

  • The way the CCG tried to avoid saying whether it will dump the hospitals Trust as the provider of existing community health services, and switch to buying them from private companies or 3rd sector/voluntary organisations, once it has completed the process of re-specifying these services.
  • The way the Scrutiny Panel failed to nail the CCG on whether its plans to re-specify and re-purchase existing community health services by the end of this year would significantly change existing NHS services in Calderdale and so require public consultation.
  • The time frame for costing Phase 2 community health services, which will happen over the next 3 months. Phase 2 would involve taking services for frail elderly people with multiple illnesses out of hospital and into the community or people’s homes.

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