Memorandum submitted by Wychavon District
Council (PCT 38)
INTRODUCTION
Wychavon is in South Worcestershire and local
health services are currently provided by South Worcestershire
Primary Care Trust. The Council was recently consulted by West
Midlands South Strategic Health Authority on initial proposals
for "Commissioning a Patient—Led NHS".
Wychavon's Managing Director framed our response,
having consulted the full Council and the Health Scrutiny Team.
The Team involved representatives of neighbouring authorities,
the Local Patient and Public Involvement Forum and community organisations
involved with health—such as the Friends of Hospitals—in
discussions. We have attached a copy of the letter, which summarises
Wychavon's concerns about the current process. (Annex 1.)
For ease of reference, we have drawn these out
against the Terms of Reference of the Health Committee for this
exercise:
1. Rationale behind the changes—whether
the proposals locally are really geared to improving health services
for patients or towards saving money. Our impression was that
the main driver locally appeared to be saving £7 million
in the West Midlands health economy.
We also expressed concern at the criteria of
co-terminosity of PCT boundaries with Social Services authorities,
in our case, Worcestershire County Council. We referred to our
experience of existing organisational arrangements and partnerships
that work well across parts of the County Council areas. Examples
include the Local Strategic Partnership and Community Safety.
We work with the PCT and County Council in the provision for Disabled
Facilities Grants, and the Housing Improvement Agencies are split
on a North/South basis in Worcestershire.
We are concerned that the use of pooled budgets
to provide services risks funding from health partners reducing
and the Council Tax payer has to fund the deficit.
2. Likely impact on commissioning of services—our
response to the Strategic Health authority refers to a local example
of where commissioning services has not been successful—the
Independent Sector Treatment Centre at Kidderminster. Our local
PCT has signed up to use a set number of treatments per month
but has so far not met that number. The PCT thus bears the risk
on the contract. Our suggestion to the Strategic Health Authority
is that it would now be timely to re-examine the contract so that
the risk is not with the public sector.
3. Likely impact on provision of local services—we
are concerned that any proposals should involve a clear statement
on the options for the management of community hospitals. From
the options we were consulted on, it was not clear how far the
PCT's would remain involved with the provision of these valuable
local services—if at all.
4. Likely impact on other PCT functions—we
did not address this specifically.
5. Consultation about proposed changes—we
were extremely concerned at the timing of the launch of the "Commissioning
a Patient—Led NHS" by Sir Nigel Crisp—at the
start of the summer holidays. The timescale for responses to the
Strategic Health Authority initial proposals was extremely tight.
We were fortunate in having the will of fellow Councillors to
engage in the discussions around this topic. Indeed, we were the
only District to respond in time for our comments to be included
in papers for the SHA Board Meeting. The County Council's response
was from an Officer and their Members were involved very late
on. The impression all along was that the proposals were rushed
and we await the public consultation—due at the end of this
month—with interest.
The forthcoming proposals from the Department
of Health need the widest possible publicity and to focus on informing
and involving the public. Our impression has been that the proposals
submitted by the Strategic Health Authority looks like a fait
accompli.
6. Likely costs and cost savings—we
refer to this aspect briefly in paragraph 1 above.
Councillors Mrs Judy Pearce and Malcolm Meikle
Wychavon District Council
9 November 2005
| 
