Warwickshire County Council (WCC) held a special meeting to debate the NHS, and the Integrated Care System, on 19th February 2019, around a motion put forward by Cllr. Les Caborn, portfolio holder for Adult Social Care and Health, WCC..
The motion reads:
This Council believes that an integrated care system focused on communities is the right way forward for the health and wellbeing of citizens in Warwickshire.
SWKONP has attempted to persuade WCC to place major amendments to this motion.
Anna Pollert, SWKONP Chair, held meetings on Thursday 14th February with Labour and Lib Dem councillors to discuss their possible support for the following amendment, suggested by John Lister editor of newspaper ‘Health Campaigns Tother’:
Suggested amendment: Delete “an” and “system” from line 1, and add at end:
“However Council also believes that a system delivering integrated care needs to be open, transparent and accountable to the people of Warwickshire, and must therefore establish a board to take its policy decisions which includes representation from the public, which meets in public, is subject to the Freedom of Information Act, and which publishes its board papers. None of these are part of the current proposals for “integrated care systems”.
“This Council further notes that despite the early rhetoric on the need to include councils in their deliberations, not one of the 44 Sustainability and Transformation Plans offered any serious proposals to address the financial problems of funding social care, or any significant influence for local councils, without which “integration” is simply an empty word
“Council notes that even now joint working with local government is only mentioned once, fleetingly, in the NHS Long Term Plan published last month. It is clear the local authorities have once again not even been consulted on the Plan, which simply suggests there is a “clear expectation” that “local authorities, the voluntary and community sector and other partners” will wish to participate (p30).
“Councils are elected bodies with a duty to stand up for the interests of local people: any support for integrated care has to be conditional on securing changes that ensure councils can play this role within them, rather than meekly rubber-stamping plans drawn up and implemented without consultation by the NHS.”
Report on WCC Meeting February 19th 2019.
Guest speakers from the NHS and voluntary sector, the public and councillors debated the motion and SWKONP members Bill Kaye, Dennis McWilliams, Anna Pollert, Martin Drew and John Lister spoke for three minutes each on the ICS.
SWKONP contributions can be seen on WCC Webcast at 1hr 4 mins in: https://warwickshire.public-i.tv/core/portal/webcast_interactive/394887
Anna sent the following press release to the local press:
SWKONP Press release 19th February 2019 SWKONP attends Warwickshire County Council debate on health and social care
Members of South Warwickshire Keep our NHS Public joined the public debate at Warwickshire County Council’s special meeting on health and social care, and its motion to support the Integrated Care System.
Anna Pollert, Chair of SWKONP, pointed out that we all support greater integration of health and social care, but a major barrier to their integration is that health care is free, but social care is not and is means tested. ‘For integration to really work’, she said, ‘social care must be properly funded and brought into public provision, free at point of use’. She also explained that what had not been mentioned in the Council’s discussion on greater ‘integration’, was the Integrated Care Provider contracts to run Integrated Care Systems. ‘These would be multi-billion pound contracts for 10-15 years, and open to public/private partnerships – with potential slippage to privatisation. If ICSs are not Trojan Horses for privatisation, NHS England should insist that the contract can only go to an NHS body or other statutory provider’.
SWKONP member, Martin Drew, turned to the starvation of social services, which, he said ‘are on the critical list. Coventry and Warwickshire will have reduced adult social care spending by £13.5m by 2020 with an extra £398,000 of cuts to disability services. Since 2010, £7 billion has been slashed from England’s care budgets with a swingeing £700 million cut to care budgets in 2018-19. This has ramped up the pressure on GP surgeries, A&E departments and other NHS services.’ How could integration work with a starved social care system?’
SWKONP supported councillors who demanded proper resources and transparency. John Lister, health campaigner and editor of Health Campaigns Together argued that local councils needed a proper input into plans: ‘a system delivering integrated care needs to be open, transparent and accountable to the people of Warwickshire, and must therefore establish a board to take its policy decisions, which includes representation from the public, which meets in public, is subject to the Freedom of Information Act, and which publishes its board papers. None of these are part of the current proposals for “integrated care systems”. Councils are elected bodies with a duty to stand up for the interests of local people: any support for integrated care has to be conditional on securing changes that ensure councils can play this role within them, rather than meekly rubber-stamping plans drawn up and implemented without consultation by the NHS.”
Cllr. Helen Adkins (Labour) also sent out the following press release:
PRESS RELEASE: FOR IMMEDIATE RELEASE
Warwickshire County Council passes Labour amendment asking the government for more money for Health and Social Care
This Tuesday, Warwickshire County Council held a Public Interest Debate which focused upon Health and Social Care in Warwickshire. The original Tory motion asked for backing for a formalisation of an integrated care system for Warwickshire. The Labour amendment, which was passed, called for more money from central government to fund such a move. This amendment comes in the light of the fact that the 2% extra levy being used to prop up Social Care for the past 5 years will end this financial year, leaving a short-fall which will have a devastating impact on the people of Warwickshire.
Labour Group spokesperson for Health and social Care, Cllr Parsons, who moved the Labour amendment, stated ‘Whilst we support the motion for an integrated Health system, it is impossible to deliver it without proper funding. There is a crisis in funding in Adult Social Care and Health and furthermore, the extra levy topping funding in this area comes to an end at the end of this year, which leaves a gap in funding which is already stretched.’ Labour Cllr Webb added, ‘We want a strong, healthy and vibrant NHS to care for the people of Warwickshire. An integrated system should be adequately and sustainably funded.’
The meeting included presentations by a number of guest speakers and an opportunity for the pubic to speak. Anna Pollert, of Keep Our NHS Public, spoke at the meeting and was pessimistic about the relevance for the formulisation of an integrated care system. She argued, ‘I do not think the County Council should support the Integrated Care System, another top-down re-organisation by NHSE and only a new name for Accountable Care Systems, the successors to the STPs. The positive-sounding word ‘integration’ hides the fact that these new ‘systems’ are still Trojan Horses for cuts and rationing of health-care, as the STPs were. ICSs will harden the fragmentation of the NHS, begun as the 44 STP footprints, into around 40 ICSs across the country. Where will the unified, comprehensive system of the National Health Service go? ICSs will be based on an Integrated Care Provider (ICP) contract, which will run for 10-15 years, be open to public/private partnerships. They will be multi-billion £ contracts, and attractive to major health corporations. If NHS England really wanted to assure the public there would be no risk of a private contractor getting the contract, they should insist that the contract can only go to an NHS body or other statutory provider.
Martin Drew, also of Keep Our NHS Public added, ‘Like motherhood and apple pie, integrating the Care System sounds like a good thing, like joined up thinking is always a good idea. Just one problem, it ignores reality: the crises across the board in health and social care caused by chronic underfunding and understaffing. Integrated Care will do nothing to address the urgent need for a major transplant of money. Coventry & Warwickshire STP, sorry, accountable care system/organisation, sorry Better Health, Better Care, Better Value/ Integrated Care Partnership will have cut £270 million during the present 5 year reconfiguration plan. As demand has risen because of an ageing population, every area has had to cut services and increase waiting times. Children’s Centres closed, A& E waiting times ballooned, mental health services continue to be starved of funding, local voluntary sector support charities have had funding cut by up to 60%. Above all, as Niall Dickson CEO of NHS Confederation stated, “Public Health and Social Care provided by local authorities are the elephants in the room. These vital services are absent in the public debate about the provision of an effective care system. Yet these services are cornerstones of the new out of hospital services. Social services are on the critical list. Coventry and Warwickshire will have reduced adult social care spending by £13.5m by 2020 with an extra £398 000 of cuts to disability services. ’
Councillor Parsons ended the debate with a call for the end to means testing for Social Care and for the NHS to remain free at the point of delivery, providing care from the cradle to the grave.
Result: Despite SWKONP attempts to explain the hidden agenda of the ICS – ie the Integrated Care Provider Contract, which removes accountability and opens the door to further privatisation, the motion was carried, although with the Labour amendment to ask government for more money.
Meanwhile, with no mention anywhere in the news, the Integrated Care Provider Contract Regulation has been sneaked through by the government to enable ICPs (Integrated Care Providers) to get established. In a previous incarnation they were STPs, then ACOs but as the US association began to tarnish their reputation the name was changed to Integrated Care Systems.
This is 9 pages long but you could just look at paragraphs 7.6, and its casual dismissal of the possibility of privatisation, saying only that the Long Term Plan expects these contracts to be run by public/statutory bodies; see also 7.10 for the same non-committal approach to privatisation. Otherwise see 7.8, 7.9, and 12.3. 12.3 also suggests private business won’t be implicated (i.e. involved).
Local news: Leamington Observer 21st February 2019: Infant Mortality Rates on the Rise.
The article points to cuts to the bone of services to parents of young children, including the planned closure of 25 of 39 children’s centres, following a £67 m cut in funding.