Calderdale and Kirklees Councillors’ Scrutiny review of hospitals cuts plans update to Secretary of State was 3 months late

This report of the 15.2.19 meeting of Calderdale and Kirklees Joint Health Scrutiny Committee outlines:

• Main concerns from Secretary of State and the public about the revised proposals for hospital cuts, centralisation and move of hospital services into Primary Care Networks

The Joint Health Scrutiny Committee’s task

•Joint Health Scrutiny Committee’s decisions at the 15.2.19 meeting

The need for the Care Closer to Home /out-of-hospital schemes for Calderdale and Kirklees to continue to be scrutinised by the Joint Health Scrutiny Committee

The NHS Organisations avoided answering two thirds of the questions asked by Councillors on the Scrutiny Committee, the Colne Valley MP Thelma Walker and Hands Off HRI and CK999 campaigners.

Thelma Walker MP (on left) with Hands Off HRI and CK999 campaigners at Calderdale and Kirklees Joint Health Scrutiny Committee meeting, Feb 2019

You can read the questions that the NHS did and didn’t answer, here

The Scrutiny Committee must get answers to ALL those questions!

The questions were about the hospitals Trust’s update report to the Secretary of State. This was presented to the meeting by Anna Basford, Director of Transformation at the hospitals Trust.

Main concerns the revised proposals must solve

The questions addressed the Secretary of State’s 3 main concerns, and additional public concerns.

The Secretary of State has asked the NHS organisations to deal with his concerns in their revised proposals for the hospitals cuts and centralisation and the move of hospital services into “the community”. These are:

  • The need for further work on out-of-hospital care – this is mainly the responsibility of the NHS Commissioners
  • The capacity within the hospitals – so the Trust now commits to retaining beds as they are until/unless there’s a sustained reduction in demand for hospital beds as a result of Care Closer 2 Home.
  • Capital financing – the Dept of Health has now allocated a £197m loan for this development.

Thelma Walker MP and campaigners presented their main concerns about the revised proposals in deputation statements:

  • Social justice demands both towns keep a 24/7 type 1 (blue light) A&E and full District General Hospital
  • There should be a full public consultation on the revised proposals
  • The proposed model for care closer to home, delivered by 14 Primary Care Networks across Calderdale and Kirklees and Integrated Care Alliances in each Local Authority/CCG area, is based on the USA’s Medicare/Medicaid accountable care model. It is designed to restrict patients’ access to healthcare, introduce surveillance medicine with all the threats to privacy that implies, and substitute inappropriate individual behaviour change schemes in place of public health measures that tackle the social, economic and environmental determinants of the so-called modern epidemics of preventable illnesses.

Joint Health Scrutiny Committee’s task

This is to make sure that the local NHS organisations’ revised proposals are in the interests of the public and the local NHS, and are properly consulted on.

If they decide they are not, they can refer them to the Secretary of State for Health and Social Care. They already did this in July 2017, with the hospitals Trust’s original Full Business Case

At their previous meeting in Sept 2018, they Scrutiny Committee had agreed that:

  • The Co-Chairs would write to the Secretary of State with an update on plans for further scrutiny of the local NHS organisations’ revised proposals for for cutting and centralising Calderdale and Huddersfield hospitals and moving services out of the hospitals
  • The Scrutiny Committee would meet again in November 2018 to review clinical and financial sustainability documents and more detailed proposals from the hospitals Trust’s Strategic Outline Case, which was due in October.

This timescale was abandoned. Instead, between 1 October 2018 and the end of January, the co-chairs held 3 private meetings with reps of the NHS organisations and one phone call with NHS Improvement and NHS England. The meetings were to sort out the process and timeline for producing and scrutinising the revised proposals.

The final version of the revised Strategic Outline Case was not produced until April 2019. On May 2nd the Trust Board approved it.

And where is Calderdale and Kirklees Joint Health Scrutiny Committee’s response to the Secretary of State?

At the September 2018 Scrutiny meeting, Rosemary Hedges, speaking for CK999, welcomed the Joint Health Scrutiny Committee’s decision to decide in public on their position on the revised proposals from the NHS organisations and Councils.

She asked the Committee to include the public’s concerns in their response to the Secretary of State and told them:

This means questioning the mantra that “maintaining the status quo is not an option” – code for “We can’t afford two District General Hospitals, because there’s not enough staff and not enough money.”

Did they? The public need to know!

Joint Health Scrutiny decisions on 15.2.19

  • They will scrutinise the revised Strategic Outline Case, Outline Business Case and Full Business Case.
  • They will meet informally before the next public Joint Health Scrutiny Committee meeting, to decide on the two local scrutiny committees scrutinising the Care Closer to Home plans for their own areas.
  • The NHS Commissioners and Scrutiny Committee need to identify which data will come to the committee, about patient outcomes of the Care Closer to Home scheme AND about numbers of trained staff available to work within the Primary Care Network/Care Closer to Home system.
  • They look forward to attending the upcoming Stakeholder Engagement Event.

Calderdale and Kirklees Joint Health Scrutiny Committee must insist on scrutinising the Care Closer to Home schemes in both Calderdale and Kirklees Integrated Care Systems.

It must not delegate that task to the two local scrutiny committees.

There must not be a post code lottery in primary and community health services.

The revised proposal is about the transformation of Calderdale and Huddersfield hospital AND community health services.

Moving services out of hospital into the community will have a massive impact on the Hospitals Trust. Only Calderdale and Kirklees Joint Health Scrutiny Committee can make sure this is in the interest of the public and the local NHS IN BOTH AREAS.

Plus, the public in both areas must have the same NHS, social care and public health and community mental health services. This is a NATIONAL Health Service, not a bunch of local health services.

You can read the questions that the NHS organisations did and didn’t answer here.

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