What’s the rush? Cornwall Scrutiny Committee to consider Accountable Care System Inquiry Report without time to read it.

Cornwall’s Accountable Care System Inquiry are apparently so pushed for time they won’t let Scrutiny see their report before the 5th Feb meeting.

Surely this is outrageous! At an Extraordinary Meeting on Monday, 5th February, at 10.00 am in the Council Chamber, County Hall, Truro, Cornwall Health and Adult Social Care Scrutiny Committee is to scrutinise the results of a 3 month inquiry into complicated proposals to set up a Cornwall Accountable Care System, but will not see the paper with the proposals until the meeting. The Agenda says this is

“due to the timescales of the Accountable Care System Inquiry.”

In other words the Scrutiny Committee want to rush this vital report through without giving themselves or the public time to scrutinise it.

How can they possibly scrutinise something they’ve not had a chance to read beforehand? Papers should always be made available 7 days in advance of a meeting both for Councillors and the public.

And anyway, what’s the rush? The Health Services Journal has today reported that NHS England has told senior leaders in various areas that they are delaying the second wave of Accountable Care Systems.

It’s unclear exactly which Accountable Care Systems are included in NHS England’s second wave – such is the quango’s furtiveness – but some time ago, NHS England told Cornwall that although it had failed to get into the first wave, they would be considered as “a fast follower“. And if Cornwall isn’t in NHS England’s second wave, there’s even less rush.

Are Cornwall Councillors and in particular Councillors on the Scrutiny Committee aware of this delay? Why not ask them? The Councillors on the Accountable Care System inquiry are listed here.

The Scrutiny Committee members and their contact details are listed here.

The Agenda for 5th Feb is here.

Cornwall STP’s GP out-of- hours service and NHS111 partner has been bought by expansionist private health care company Totally Ltd.

In other news relating to Cornwall Sustainability and Transformation Plan, Vocare Ltd – a partner alongside Royal Cornwall Hospitals Trust and Kernow Health Community Interest Company in the STP’s “radical change” of  out of hospital services – has been bought by private healthcare company Totally Ltd.

Its Chair Bob Holt says Totally Ltd intends to use this purchase to expand and corner “a massive market opportunity” in out-of-hospital services. He says the £10m purchase of Vocare Ltd has increased Totally’s income from £10m/year to £100m/year.

Part of that increase will be due to Cornwall STP’s £48m 5 year contract with Vocare Ltd for the GP out-of- hours service and NHS111, with a start date of 1 December 2017.

Cornwall Sustainability and Transformation Plan’s radical changes to out-of-hospital services involve replacing  community hospitals with “Integrated Community Hubs” (p42) “co-located with Urgent Care Centres to ensure workforce and financial viability, working in partnership with the acute trusts.” (p42). This is to cut £24m costs.

Reconfiguring the NHS 111 and out of hours GP services, through the new Public Private Partnership, is:

“an essential component of a wider urgent care pathway which is aligned, efficient and appropriately resourced.”

Sec of State Jeremy Hunt told the Health Select Committee on 23.1.18 that Accountable Care was not a vehicle for NHS privatisation. But Totally Ltd Chair Bob Holt told IGTV – “the only broadcast channel providing up-to-the-minute trading ideas – that,

“This is a large market. The NHS currently outsources £20bn of services. Clearly we’d like to take quite a bit more of that.”

Go figure. And if a profiteering company can make money out of out-of-hospital care, that means that taking it out of the NHS removes the possibility that the NHS can cross subsidise its far more costly acute and emergency services from the less costly out of hospital sector. But even that doesn’t add up, since professional bodies who are concerned with patient care and clinical excellence, rather than profit, have pointed out that in fact care in the community, done properly, does not save the NHS money but is likely to cost more. So where are we heading with  increasingly privatised out of hospital care, that will put profits ahead of patients – and staff’s working conditions and terms of employment?

Is Cornwall Scrutiny Committee going to take this aspect of Accountable Care Systems into account when scrutinises the Accountable Care System Inquiry report on 5th Feb? Because there is no doubt that one of the agendas and effects of Accountable Care Systems is to cut hospital beds and services and substitute out of hospital care – which, as Bob Holt the Totally Ltd Chair so happily pointed out, is a “massive market opportunity” for private companies. In this respect Accountable Care Systems are a Trojan Horse for NHS privatisation.

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