30th January 2018
By Graham Smith
The timetable for Cornwall’s health service to transform to a council-led Accountable Care System is drawing to a close.
Tomorrow (Wednesday) sees the final Inquiry Panel hearing. Its six members will make recommendations which will go to an extraordinary meeting of the council’s Health & Adult Social Care scrutiny committee meeting on Monday (5th February.)
The council has said no background papers will be available before that meeting on Monday. It has still not published an outline business case for the ACS, nor a risk assessment. Members of the public will be allowed a maximum of 10 minutes for questions. But it appears that any opportunity for councillors to influence the future will have to be made at Monday’s meeting.
While almost everyone agrees that greater integration between health and social care is highly desirable, some councillors believe it would make more sense to transfer the councils’ responsibility for social care to the NHS, rather than to let the council take charge of everything.
Recommendations from the scrutiny committee will then be discussed at a cabinet meeting on 28th March and the ACS, in “shadow” form, will launch formally on 1st April.
Public anxiety over the future of the health service in Cornwall continues to grow, with protests outside County Hall becoming a regular event alongside the Inquiry Panel hearings. A further protest is planned for tomorrow.
On Friday, former St Ives MP Andrew George hosted a public meeting in Penzance, attended by around 200 people, which produced a broad measure of agreement about the need for further NHS cash but which largely steered away from the more controversial proposal to let Cornwall Council take charge of all strategic health commissioning.
Former St Ives MP Andrew George addresses Friday evening’s audience
The ACS model is strongly advocated by council officials, particularly chief executive Kate Kennally, who has corralled the support of the Liberal Democrat led cabinet – despite the reservations of many rank-and-file Lib Dem councillors. With the cabinet votes already in the bag, the only realistic chance of thwarting Ms Kennally’s ambition would be a formal “call in” by the health scrutiny committee.
The ACS/ACO model (the council-led proposal started as an Accountable Care Organisation and does not appear to have changed, except in name) alarms NHS campaigners because the structure lends itself more easily to privatisation.
So far, the council-led ACS model is the only model discussed by the council’s Inquiry Panel. All of the witnesses, so far, have been supporters of this model despite the large number of potential voices offering a different point of view.
An alternative model, also considered by NHS and council officials as part of their quest for integrated commissioning, is the less radical proposal to take adult social care out of council control and transfer it to NHS Kernow. The background to this was laid bare in the blood-curdling turf war between the two organisations which led to Ms Kennally taking over as chair of the Sustainability & Transformation Plan at the end of 2016.