Public deputation statements to the 7 Sept 2016 Joint Health Scrutiny Committee meeting, on the Right Care Right Time Right Place consultation findings
These are the questions members of the public asked the Committee to take into account, and get answers to from the Clinical Commissioning Groups and the hospital Trust staff who were present at the meeting.
Here they are in the order in which they were presented to the JHSC.
I would like to raise a bullshit alert about the so-called Independent report by Midlands and Lancashire Commissioning Support Unit, on the consultation findings.
IT FINDS THAT MOST PEOPLE SAID THEY WOULD BE NEGATIVELY AFFECTED BY THE PROPOSALS.
ACCORDING TO THE INDEPENDENT REPORTERS, WE ONLY SAID THIS BECAUSE WE DON’T UNDERSTAND THE DETAIL OF THE PROPOSED CLINICAL MODEL.
This is basically telling the CCGs that they don’t need to rethink their proposals, they just need to convince us we don’t understand them and then try and convince us to see them their way – which in their eyes will mean we then understand them.
It’s NOT that we don’t understand them. We do understand them, and that is why we reject them
FLAWED CONSULTATION PROCESS
From the start Calderdale and Kirklees 999 Call for the NHS and the various member organisations protested at the flawed Consultation document, survey and pre-consultation business plan, and argued strongly for the Consultation to be postponed until the CCGs corrected the many errors and omissions in their consultation document.
Our pleas were ignored by all the powers-that-be, from the CCGs to the Joint Health Scrutiny Committee, and the consultation started on the basis of seriously inadequate consultation materials
During the consultation, we attended most drop in sessions and asked questions that aimed to clarify and make good the flaws in the consultation document – which has to be the cause of any public confusion about the proposed clinical models.
We received NO adequate answers to our questions at the drop in sessions.
We next wrote to the CCGs with a list of 38 separate flaws in the consultation document and pre consultation business case, asking for the CCGs to correct them and to make their answers accessible to the public.
It took more than a month for the CCGs to respond and when they did, their replies did not answer our questions: the mostly either denied the validity of our questions, or simply repeated the information that we had questioned.
We made a detailed response to the CCGs’ replies and posted it on our blog and over social media.
I have emailed Councillors this document, for your information.
In the remaining public meetings and drop in sessions we persisted but failed in trying to get adequate answers to our questions.
Since the consultation ended, on behalf of CK999 and its member organisations, I have written to Calderdale CCG and the Right Care Porgramme manager asking for adequate answers to our questions in advance of the 13th September stakeholder engagement event on the consultation findings. They have refused.
It is our clear contention that the CCG’s failure to provide full, accurate information to the public means the consultation process has been deeply flawed and has not been fit for purpose.
We think it is a cop out for the so-called Independent report on the consultation findings to say that respondents have rejected the clinical model because we don’t understand how it would work.
Although the consultation documents and face to face sessions were vague about the details, there is enough information from elsewhere about how this proposed clinical model works, and enough professional and patients’ analysis of its shortcomings, for us to understand it all too well. And this is why respondents have rejected it.
I urge the JHSC to reject the consultation findings on the grounds that the consultation process was deeply flawed and not fit for purpose.
A final point is, that the report says there is evidence that many respondents accept the need for change.
So why doesn’t the report list the kind of changes advocated by the public both at meetings and in the consultation responses?
Like proper NHS funding and an end to NHS marketisation and privatisation?
Cristina George on behalf of Hands off HRI
A lot of people’s questions prior to the consultation were never answered and those that were, were answered inadequately.
People found the survey difficult to understand and respond to.
We need to understand that since the proposals have been put forward, there have been a lot of other changes to the landscape that will affect the proposals:
- There has been reduction of services at Barnsley hospital – this is likely to be the thin end of the wedge and further services will disappear – so how will HRI patents be able to go there?
- Kirklees LMC has come out against the proposal [and so has Calderdale LMC- Ed.]
- Possible closure of Honley ambulance station [and Todmorden ambulance station – Ed] despite the need for an extra 10K ambulance journey hours per year. Paramedics say this means ambulances will be in the wrong place at the wrong time
There’s no way of knowing if community care will be in place.
Hands Off HRI have talked to Save Lewisham Hospital about the support Lewisham Council gave their campaign. Following the end of the JHSC, Hands Off HRI will look for support from Kirklees councillors. We’re waiting for councillors to follow up their election commitments to support HOHRI with some action.
Sustainability and Transformation Plans – what effect are these going to have on the proposals? We’ve raised issues about them and been told they’ll be answered later.
If Drs Ollerton and Brook don’t make good their promises and listen to public – hope they do, but if not – they should reconsider their positions.
Christine Hyde’s Deputation to Joint Health Scrutiny Committee 7:09:16
Assumptions spoken of in your papers for the last meeting, in the light of North Kirklees experience:
The CCGs said they would ensure there was capacity in community services to manage the reductions in hospital admissions, through the Care Closer to Home (CC2H) specifications. This is an assumption which can not be relied upon.
At the Meeting the Challenge Consultation, CC2H was held up as the panacea for the cuts and closures of beds in Dewsbury District Hospital but 3 years later, on 23 August this year, North Kirklees CCG had to admit there were ‘operational pressures’ – i.e. staffing problems – at the Care Closer to Home provider, Locala.
Given the climate of disillusionment amongst all staff on the front line in health provision, due to pay cuts, lack of funding and government policy attitude, I can not see any improvement is likely in the further 3 to 5 years it will take for these proposals to come into force and that is even without the cuts to be imposed by the Sustainability and Transformation Plans. Kirklees people will be at risk.
Dr Brook said GPs would wish to stay in Calderdale if they were part of a better- functioning integrated healthcare system. However the phrase ‘better functioning healthcare system’ seems to me to be a euphemism for further distances to travel for patients: i.e. someone living in Hebden Bridge, may have to travel to Halifax for an appointment, someone in Lindley may have to travel to Meltham, depending on the day, as a Federated GP service on an APMS contract ‘superstore style’ arrangement would be all that is on offer.
It seems the whole profession of doctoring is being de-professionalised and all types of medical practitioners are losing their ability to diagnose and refer patients, being increasingly bound by rigid protocol, designed to be ‘cheap’.
The single point of access to certain services in North Kirklees is presently not controlled by medical professionals but call centre workers, when indeed you can get through to one. This trend is set to continue, it seems to me, when I hear the Kirklees LMC has not been involved in decision making or given a choice with regard to proposals for Huddersfield and Calderdale hospitals.
Given that NHS Improvement has emphasised involving partnerships with the private sector in the Sustainability and Transformation Plan agenda, and that the stated aim of Jeremy Hunt is that the NHS is for “prevention rather than cure” – his words not mine, the pathways for patients in the future are uncertain, more convoluted and most likely more expensive for less service.
Accountable Care Organisation is a phrase which is increasingly used, and the one in Northumberland has needed a Special Purpose Vehicle, to set it up. That is exactly the same sort of financial product used for PFI hospital buildings. The proposed service changes to CHFT will inevitably have been included in the Sustainability and Transformation Plans, which demand a clearing of all NHS “deficits” in 6 months so how is it going to work? Therefore people with the will to do so should say STOP.
Jane Rendle – Calderdale 38 Degrees NHS campaign
I am calling on the JHSC to find out from the Clinical Commissioning Groups and Calderdale & Huddersfield hospital Trust what effect the West Yorkshire and Harrogate “footprint” Sustainability and Transformation Plan is going to have on the Right Care Right Time Right Place proposals.
Members of the public repeatedly asked this question throughout the second half of the consultation period but were brushed off or ridiculed. So I am asking the JHSC to get hold of this information now.
The STPs have changed the financial basis for the hospital reconfiguration that was laid out in the pre-consultation business case and consultation documents.
The STPs require swift elimination by the next financial year, of the collective West Yorkshire and Harrogate NHS “deficit” – the result of six years of government under-funding. They also require cuts to NHS services in line with the projected £22bn/year underfunding of the NHS in England by 2020.
This means West Yorkshire “footprint” STP must make savage NHS cuts on a West Yorkshire-wide basis. The secrecy of the process means we have no idea where these cuts will fall. The JHSC needs to find this out.
As part of the STP, NHS England and NHS Improvement have imposed a so-called “control total” on Calderdale & Huddersfield NHS Foundation Trust – ie the amount it can spend this financial year. This “control total” requires the Trust to more than halve its planned £40.5m deficit this financial year, to £16.5m.
So what is it going to have to cut, to make this extra £24m “deficit” reduction possible?
We know that discussions about this and other STP conditions have been going on between NHS Improvement, NHS England and CHFT, but we have no idea about the substance of these discussion.
Because of the STP, CHFT has been told it can’t carry out its plan of recruiting more staff from 1 October this year – so how it is going to solve its problem of staff shortages and reliance on expensive agency staff?
And how is CHFT going to meet a condition of S&T funding, that it must have a recovery plan in place that shows when the Trust will break even, within a “reasonable timeframe”?
Because the Right Care Right Time Right Place pre-consultation business case shows CHFT in deficit for at least the next decade; and no one during the public consultation drop ins was able to say at what point beyond 2026 CHFT might break even.
The JHSC needs to find out what is in the West Yorkshire and Harrogate “Footprint” STP and how this affects the RCRTRP proposals.