Anyone who wants to find out about the sell off of our NHS, and understand how this is going to affect patient care, has their work cut out as the plot thickens around the £238m Huddersfield and North Kirklees contract for Care Closer To Home.

This contract is to take services out of the hospital and integrate them into community health and social care services for chronically ill and frail elderly people, with the aim of cutting acute and A&E hospital admissions and services. This is in order to cut NHS spending. Otherwise a £22bn NHS funding gap is predicted to open up by 2020.

The award of the contract has been at a standstill for a month. Yesterday the Health Service Journal reported that the massive contract has gone to a consortium led by Locala, the community health company that was set up in 2010 with staff and assets transferred from NHS Kirklees Primary Care Trust.

The organisations involved – the Clinical Commissioning Groups and Locala – maintain that the contract is still at a “standstill”.

Despite the confusion, Calderdale and Kirklees Councils’ Joint Health Scrutiny Committee (JHSC), which meets in Huddersfield Town Hall, 10.30 am on Monday 29th June, has no plans to ask Greater Huddersfield Clinical Commissioning Group what’s going on. Which rather gives the lie to their earlier promise that they would closely scrutinise this contract.

Why does it matter?

It matters because – as Greater Huddersfield and North Kirklees Clinical Commissioning Groups explained in their refusal of a Freedom of Information request – commercial interests are overriding what even they admit is a:

“strong public interest in transparency and accountability within the NHS”.

This is our NHS. We pay for it, we own it and we need it to work effectively, for all of us.
When we can’t figure out what’s going on with it, because commercial interests dictate secrecy,  there’s something seriously wrong. Not only with the NHS, but with democracy.

So I emailed the Chair of the Calderdale and Kirklees Joint Health Scrutiny Committee (JHSC) to ask what was going on.

Her reply, sent by the Kirklees Scrutiny Officer Richard Dunne, was

“As I’m sure you can appreciate the Clinical Commission Groups (CCG’s) are still going through due process and have still not announced the preferred bidder. The CCG’s have reiterated that they will make no comment until they have made the announcement. The announcement will be made in the most timely manner possible and it would not be appropriate to comment further at this stage.
I hope that you can understand the reasons why it would not be appropriate to make any specific comments at this time but please be assured that the Calderdale and Kirklees Joint Health Scrutiny Committee is committed to thoroughly investigating the proposals that emerge from these developments and its impact on patients and the public.”

But by then it will be a case of shutting the stable door after the horse has bolted

Surely what is needed now is for the JHSC to immediately call in the Clinical Commissioning Groups (CCGs) to scrutinise:

• the process which the CCGs have used to award the contract
• 
the reasons for the month-long standstill on announcing the contract award – we know from the CCGs’ reply to a Freedom of Information request that this is because the losing bidder “has raised concerns”, but the CCGs have refused to say that these concerns are
• 
the reportedly chaotic competitive dialogue process that the CCGs used to develop the contract specifications and decide on which bidder to favour
• the cost of the tendering and contract award process – both to the CCGs and to the two bidding consortia
• 
how and why the information about the award of the contract to Locala was made to the Health Service Journal
• the lack of public consultation about the Care Closer to Home proposals, which means that most people don’t have a clue about what they amount to
• how the value of the £238m Care Closer to Home contract compares with the cost of providing community health services under Locala’s previous contract
• what the resulting loss of income from losing the Care Closer to Home contract will be to the two hospital trusts – Mid Yorkshire and Calderdale and Huddersfield.
• 
the extent to which this will further destabilise the struggling hospital trusts
• whether the CCGs took this into account when awarding the contract to Locala

Why not use Monday’s JHSC meeting to ask these questions? They would fit in under Item 4 of the agenda: update of Right Care Right Time Right Place, for which CCG representatives will be present.

This update says nothing about the award of the Kirklees £238m Care Closer to Home contract to Locala, even though Care Closer To Home is one half of the Right Care Right Time Right Place shake up, with acute and A&E hospital cuts and closures the other half.

Clinical Commissioning Groups refuse Freedom of Information Request – commercial confidentiality overrides strong public interest in NHS transparency and accountability

Equally, no useful information has emerged in a reply from Greater Huddersfield and North Kirklees CCGs to the Freedom of Information request about the award of the Care Closer to Home contract.

The CCGs’ reply, sent today to Kirklees citizen Terry Hallworth, says that the CCGs are not making public which consortium they’ve decided to award the contract to because:

“…one of the bidders has raised concerns and it is proper that the CCG carefully considers these concerns before issuing the contract award notice…”

They say that in this situation,

“the strong public interest in transparency and accountability within the NHS”

is outweighed by the fact that it is in the public interest to withhold information about who the preferred bidder is, so that the procurement procedure can be followed.

They refuse to say what the unsuccessful bidder’s concerns are, because the concerns were raised in confidence as part of the bidding process.

The CCGs are:

“not aware of a formal challenge having been issued.”

They also refuse to reveal the bid values of both bidders, on the grounds of commercial confidentiality for both the bidders and the CCGs. They say that making the bid values public

“would be likely to enable competitors to undercut such proposals…, provide competitors with an unfair competitive advantage and undermine bidders’ ability to compete on an equal footing in the market for such services or the wider health economy…This would be likely to have the knock-on effect of prejudicing future tenders for such services by the CCG and thus would be likely to prejudice the CCGs’ commercial interests also.”

So commercial interests for both commissioners and providers override transparency and accountability within the NHS. According to the Clinical Commissioning Groups.

But what about the Councils?

They are made up of Councillors who are democratically elected by the people, and have a duty to hold the local NHS organisations to account and to make sure that they don’t damage health services for people in the area.

So surely they must put the strong public interest in NHS transparency and accountability, above commercial interests?