Will the NHS in Cornwall end in February?
There have been some scary stories on the internet over the past few weeks claiming that a handful of councillors (including me!) will be making a decision on February 8th to take Cornwall out of the NHS and hand all of our health services over to a private company!
Unsurprisingly, this has caused a great deal of alarm for many people in Cornwall, both staff and patients alike. I have received quite a few emails and there have been several protests.
Let's get a few things straight:
- Everyone agrees that the NHS in Cornwall is in crisis. The Emergency Department at Treliske is regularly on Black Alert with ambulances stuck outside unable to hand over their patients.
- Cornwall needs more funding from central government. The NHS is underfunded nationally AND Cornwall gets less than its fair share compared to other areas. Cornwall Council provides Adult Social Care but our main grant from central government has been cut by over 70% in the past 5 years, so even though council tax goes up every year, the Council has to keep making cuts.
- However, even if we had more money, there would still be problems. There simply aren't enough doctors and nurses in the country to keep up with the increasing demand, and the Care Quality Commission recently branded Cornwall's health and care system as "Inadequate" because the various NHS providers are not cooperating effectively with one another or with Cornwall Council.
Cornwall Council and the NHS have been working together for the past 18 months to design a new way of working which will provide better care and support, closer to home, helping people to stay healthy and to deal with illness promptly so that it doesn't develop into something more serious. This should mean fewer people needing to visit the Emergency Department or being admitted to acute hospitals. This will be better for patients AND it will save money.
A lot of work has already gone into these plans, but too few people know about them. You can see the latest info and add your own comments by visiting www.shapingourfuture.info
Most of the information on the website describes how services will be organised at the front line. The aim is to create a joined-up service so that patients don't feel like they're being passed from pillar to post (a common complaint about the current system). HOWEVER, for this joined-up service to work, there need to be some changes behind the scenes. For decades, governments of all parties have broken the NHS up into separate "providers" who "compete" against one another in an "internal market". This was meant to lead to innovation and efficiency, but in reality it just makes it harder for front-line staff to do what's best for the patient in front of them. How can we get smooth transfers from acute hospitals to community hospitals, when both hospitals and the ambulance service are all run separately?! How can we get patients home from hospital more quickly if they need a package of healthcare (from the NHS) AND social care (from Cornwall Council)?
Cornwall Council and the NHS are now working on plans to create an "integrated health and care system" which promotes collaboration instead of competition.
I am one of six councillors holding an inquiry into how this new integrated system could work. At the end of January, we will bring a report to the Health and Adult Social Care Overview and Scrutiny Committee. This committee will give the Cabinet a recommendation on which possible options should be investigated further. The Cabinet may instruct officers to produce a "draft business case" for the preferred option, but this will take several months to produce.
As you can see, there is plenty of time for concerns to be investigated before any final decision is made. I have also called for the final decision to be made by the Full Council (not just the Cabinet), and I am pleased to say that this has been agreed by the Leader of the Council.
I have put together a list of 30 concerns raised about the proposals. Many of them appear to be based on misunderstanding and rumour (e.g. lots of people think we are handing the NHS over to an independent "Accountable Care Organisation" which can write its own rules, charge patients and keep profits for private owners). The aim of the inquiry is to ensure that all of these concerns are properly investigated. I will not support any changes to the NHS and Social Care in Cornwall unless I am happy that these concerns have been properly answered. Click HERE to see my list of questions for the inquiry.