Analysis: Have Cornwall’s Liberal Democrats just saved the NHS?

Analysis: Have Cornwall’s Liberal Democrats just saved the NHS?

2nd March 2018

By Graham Smith

Political courage is something not often associated with Cornwall Council, yet within 24 hours two distinct yet connected news stories have revealed something about our local politicians which perhaps previously has gone unrecognised.

The gob-smacking decision of the council’s cabinet to scrap plans for an Accountable Care System will not please the council’s chief executive, Kate Kennally.  She has been pushing energetically for a restructured National Health Service ever since she replaced NHS England’s choice to lead the Sustainability and Transformation Plan, in November 2016.

The decision by cabinet members Rob Rotchell and council leader Adam Paynter, to pull the plug on the ACS, cannot have been easy.  But it was undoubtedly the correct decision and they deserve full credit.

Large bureaucracies often work like out-of-control oil tankers in a typhoon.  They have poor steering and no brakes. The temptation to let the ship run on auto-pilot, trusting that the technocrats know what they are doing, can be overwhelming.

Dazzled by the prospect of cash savings, and the political kudos of “rescuing” the NHS, many Cornwall councillors were happy to play the role of ACS cheerleaders and chant their support for “Option 6” – a new organisation, based at County Hall, combining health and social care within a single pooled budget.

There were plenty of warnings that the risks associated with an ACS outweighed the benefits.  But these warnings appeared to go unheeded in Cornwall, particularly among those councillors who believe “local” is always better.  A special Inquiry Panel was convened and quickly, almost comically, found that the proposed ACS was the right thing to do.

It is important to note that all of the players in this soap opera were united in their ambition to integrate health and social care.  But such integration was already happening, without the new empire-building which has occupied so much time on the fourth floor at County Hall.

Outside, in the cold and the rain, health campaigners waved their placards and shouted “Say No To The ACO.”  The debate became increasingly party political.  Lawyers huffed and puffed.  Social media, and this news website, kept asking questions.  But the Kennally Care juggernaut seemed determined to meet its 1st April deadline.

Then late last week came news that council leader Mr Paynter had intervened to scrap a special briefing session for all members of the council, due to have been held two days ago.  An email from Ms Kennally to all council members subsequently implied that she knew nothing about it.

Mr Rotchell is an NHS man through-and-through.  Some councillors feared that his move from chairman of the Health Scrutiny Committee, where he had been outstanding, to become the cabinet member responsible for health and social care, would see him turn from poacher to gamekeeper.

Now we know that, in fact, Mr Rotchell had finally concluded that the ACS game was not worth the candle.  His previous assessment last summer of the STP public consultation exercise as “not fit for purpose” saw him take a position from which it would be difficult to retreat.  When it came to the crunch, he did not retreat.

Councillors are there to exercise political judgement and apply common-sense when over-excited officials allow ambitious and eye-catching projects to get the better of them.

Cornwall Reports has long been a critic of Accountable Care.  It is perhaps going too far to say that Cornwall’s Liberal Democrats have saved the National Health Service, but Cornwall Reports applauds both Mr Paynter and Mr Rotchell for having the guts to do what was right, rather than what was easy.


Outflanked: Adam Paynter, Kate Kennally, Rob Rotchell

They risked – and maybe still risk – looking foolish.  Many in their own Liberal Democrat party are asking “what’s going on?”  But it takes courage for part-time local politicians to stand up to a full-time £180,000-per-year clever, articulate, chief executive.  Maybe a precedent has been set.

The full details of the U-Turn have yet to become clear and councillors across the political spectrum will want to know why it took so long.  Expect some councillors who had previously supported an ACS to now claim that they had really been against it all along.  But better late than never.

The council’s cabinet was told on Monday.  Having previously expected to vote on the ACS at their meeting on 28th March, it now looks as if there will be nothing to vote on.

There will however be an all-member briefing on 21st March, with two hours allocated for discussion about the ACS.

There is no shortage of obvious questions, such as how much time and money has been wasted on this project over the past 18 months?  How many thousands of pounds have been spent on consultants, such as US-based GE Healthcare Finnemore and Price Waterhouse Coopers?  How did the council’s Inquiry Panel get it so wrong?  Why did the Health and Social Care Scrutiny Committee vote unanimously to proceed with Option 6?

That scrutiny committee vote now looks even more bizarre and leads to the second story of political courage this week.  The committee’s proposal to recommend “Option 6” was proposed by Conservative councillor Andy Virr and seconded by (then) Labour group leader Tim Dwelly.

Tim Dwelly and Cornelius Olivier

Mr Dwelly went out on a political limb, and was applauded by both Tories and Liberal Democrats for defying his own party’s policy.  But his “independence” came at a price, with nearly 100 Labour activists in Cornwall subsequently asking fellow Labour councillor Cornelius Olivier to stand for election as leader of the small Labour group.   Mr Olivier had attended all of the ACS Inquiry Panel meetings.  Mr Dwelly attended none.

Politics is not meant to be quiet.  It is all about disagreement over policy, and there is no shortage of policy differences between Mr Dwelly’s old New Labour and the new Old Labour activists.   Mr Olivier showed courage in being prepared to challenge Mr Dwelly, and to offer a choice.

Mr Dwelly survived his group’s Annual General Meeting, but a few weeks later decided to not just step down as group leader but to quit the Labour Party all together.  That was another decision requiring courage – although whether Mr Dwelly’s bravery extends to a willingness to resign his council seat, and fight a by-election, is another matter.

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