Memorandum submitted by Martin Avis
I have just read the memorandum from Jane Hanna
and wish to support its factual content and details regarding
the opthalmic centre saga in SW Oxfordshire. The manner in which
this process was conducted was a sad failure of the process of
national and local decision making in the NHS. I raised the question
as to the individual PCT's responsibility to take decisions on
the basis of the evidence presented to them at two meetings of
the Chairman of NHS Trusts in the Thames Valley SHA. Nick Relph
and Jane Betts, Chief Executive and Chair, were present on both
occassions, the second being in September 2003. It was understood
and accepted by all that it was the individual Boards decision
and to be taken in the interests of their population unless directed
in writing concerning overriding national interests. However,
subsequent discussions with individual Chairs indicated that if
advised verbally by the TVSHA that their jobs were at risk they
would ensure their Board voted the way they were told. Two had
been told they had to get their Boards approval of the Opthalmic
centre proposal or their jobs would be lost. I was never directly
threatened regarding my job until after my Boards rejection of
the opthalmic proposal in November 2003. The "inability"
of the TVSHA or the top NHS officials to put in writing that the
SW Board must vote in favour of the opthalmic centre proposal
in the national interest meant the non-executives present rightly
opposed the proposal on the evidence before them. It did not demonstrate
a benefit to our population and did not deal satisfactorily with
substantial potential risks, which have subsequently become real
financial burdens to an area already exceeding its budget. The
Chairman of Cherwell Vale PCT and myself requested, in December
2003, an internal review of the lessons to be learned from the
process that led to the no vote at SW PCT and a fraught lead up
to the yes vote at Cherwell Vale PCT. This request was directed
to John Reid. No review ever took place. I am sure that what happened
to myself and the SW Oxfordshire PCT non-executives has weakened
local decision making and ensured the TVSHA continues as an outpost
of the Department of Health. Local Trust Boards will tend to rubber
stamp decisions recommended by their executives rather than risk
their jobs in upholding local interests. I am concerned about
the difficulty for Chairs and non-executives in holding their
executives to account when these executives careers and interests
lie in conforming to political and civil service pressure applied
in covert ways.
Martin Avis
Emeritus Professor Oxford Brookes University
Manager Oxfordshire Carers Forum
Ex Chairman of SW Oxfordshire PCT
Please use this memorandum in support of the Jane Hanna submission
24 November 2005
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