31st January 2018
By Graham Smith
The chairman of the Cornwall Council scrutiny committee which will consider the authority’s proposed takeover of the National Health Service has promised his members will be given “all the time they need” to read and digest an Inquiry Panel report, which is currently not expected until the morning of the meeting.
The Health & Adult Social Care scrutiny committee is due to meet at 10am on Monday (5th February) to make a recommendation to the council’s cabinet. But council officials are currently warning that background documents and reports, including the report of the six-member Inquiry Panel, will not be available beforehand. The panel has been meeting today (Wednesday.)
Councillor Armand Toms, the committee chairman, has told Cornwall Reports that if necessary Monday’s meeting will adjourn to allow for proper consideration of the documents before any debate is started.
Mr Toms was responding to criticism of the way senior council officials, particularly chief executive Kate Kennally, appeared to be rushing towards a notional “deadline” of 1st April for launching a shadow Accountable Care System. Ms Kennally would be in overall charge of the new system, which some have dubbed “Kennally Care.”
“We obviously can’t debate a report if no-one has read it,” said Mr Toms. “I am encouraging officials to work all weekend, if necessary, to get the papers out to members so that they can read them in advance. But if that’s not possible, then Monday’s meeting will just have to adjourn so that members can be given all the time they need to read the documents.
“It’s a complicated area of policy and it needs to be given a proper discussion.”
The Inquiry Panel seems likely to endorse Ms Kennally’s vision of the future but Mr Toms said members of his committee would be free to table amendments. In total, officials have identified six alternative options for better integration of health and social care. The “Kennally Care” option, which calls for the creation of a “new vehicle” for commissioning and delivery of all health services in Cornwall, is only one of those options.
The final Inquiry Panel meeting today was again told the council should not rush to launch any “new vehicle” on 1st April.
The panel heard for the first time from organisations which have reservations about any Accountable Care Organisation or System. The council’s cabinet is due to vote on the proposal on 28th March, pending the outcome of the scrutiny committee meeting on Monday.
Stuart Roden, of Unite, said he was concerned at the lack of staff engagement or consultation and warned that the “existing crisis in the workforce” would get worse unless council and health bosses adopted a more collaborative approach.
“Something like 20,000 people work in the care sector in Cornwall,” he said. “It is much larger than our manufacturing sector and most of those people work in the private sector.”
He also feared that what might “start as a soft ACS” could quickly develop into an Accountable Care Organisation, eventually required to tender large health contracts in the private sector.
Another wet Wednesday morning: the by-now familiar sight of protestors urging the council to reject “Kennally Care”
His concern was echoed by Inquiry Panel member councillor Loveday Jenkin, who asked: “How do you stop something happening once it’s started?”
Mr Roden suggested that instead of moving to create a new vehicle to commission and deliver all health services in Cornwall, it should be possible to build on existing arrangements. “We all agree that integrated commissioning of health and adult social care is a good idea,” he said. “To some extent that’s what they’ve done in Manchester. So why do we need to set up a new vehicle by 1st April? What’s the rush?”
Mr Roden’s observations were given added weight by senior officials from the council’s own Adult Social Care department. Trevor Doughty and Jonathan Price said officials had jointly come to a view supporting the establishment of a “new vehicle” but pointed out that joint commissioning of some adult services, worth millions of pounds, was already happening.
At an earlier hearing the council’s chief executive, Kate Kennally, had repeatedly made the point that “doing nothing is not an option” as she drove home her desire to set up an Accountable Care System, with herself as the Single Strategic Integrated Commissioner.
While careful not to disagree with his boss, Mr Price offered a more nuanced position: “We all agree that doing nothing is not an option,” he said. “But we’re not ‘doing nothing’ at the moment. We are doing something. Building blocks are already in place, to have one budget and one plan.”
Mr Doughty added that work on pooling budgets between the council and the NHS for adult social care was already well underway. “Investment in social care is crucial for the future of the health service,” he said.
Inquiry Panel members appear to be taking positions based on party political lines – with the panel’s Conservative and Liberal Democrat members reluctant to challenge the clear course charted by the council’s chief executive.
A growing number of backbench councillors, across all parties, however, believe nothing would be lost if the nominal launch date of 1st April was put back until after the outcome of two separate Judicial Review hearings, and a Parliamentary Select Committee investigation.