EXCLUSIVE: Council signs the deal and takes charge of health, setting up “Kennally Care” before even the first question is asked
16th December 2017
By Graham Smith
The deal is done and the contract signed
Community hospitals at risk
Cornwall’s healthcare to be re-branded
No change to terms and conditions of healthworkers
Many questions still unanswered
Public consultation during the next year before the ACS takes full control
Cornwall Council has signed the “accord” which puts itself in charge of health services, concluding an important element of the 2015 “Devolution Deal” which was designed to transfer powers from Whitehall to Truro.
The deal means that overall strategic health commissioning decisions will rest, ultimately, with elected local councillors for the first time since 1946 – when an infant National Health Service grew out of services then co-ordinated by the former Cornwall County Council.
The cabinet portfolio holder for health, Camelford councillor Rob Rotchell, went to County Hall in Truro yesterday (Friday) to sign the document which will create a shadow Accountable Care Service with effect from April.
As Cornwall Reports revealed on 4th December, the heads of agreement had been prepared well in advance of next week’s Inquiry Panel hearing.
Protestors planning to lobby that meeting, on Tuesday morning, are likely to be furious that even before a single question is asked, and with zero public consultation, the council’s officials have already set off in a direction which some fear could break up the National Health Service and lead to greatly increased privatisation.
“The accord is to move to shadow status, but not the full ACS,” Mr Rotchell told Cornwall Reports. “That will happen after a year. There’s an awful lot of work that still needs to go on. The key thing is that the ultimate decision will be made after the inquiry and scrutiny hearings which need to take place. And that final decision won’t be for another year.”
Last month the council’s chief executive, Kate Kennally, who is to become the Single Commissioner at the top of the new structure, set a timetable which was supposed to lead to a cabinet decision to approve the shadow ACS on 7thFebruary. That cabinet meeting now appears to be a waste of time, as Mr Rotchell has already signed the contract under his delegated authority as the portfolio holder.
Ms Kennally’s interest in running Cornwall’s health services has been apparent for some time, following her takeover as chair of the Sustainability and Transformation Plan 12 months ago. Some wags have coined the term “Kennally Care” to describe the ACS.
In a wide-ranging interview, Mr Rotchell said there were still many details of Cornwall’s new approach to healthcare which he did not yet know. But he did reveal some new information:
- He thinks Cornwall Council must now undertake its own public consultation
- Cornwall’s health organisations, primarily the Royal Cornwall Hospital Trust and the Cornwall Partnership NHS Foundation Trust, are to be re-branded as a single organisation. The new name, and any logos, have yet to be agreed. Mr Rotchell thinks the analogy with the 2009 local government reforms, when Cornwall’s district councils were merged to form the unitary Cornwall Council, is a fair description of what is now happening in health.
What would Nye Bevan make of it? Kate Kennally’s Accountable Care System now exists, in shadow form, without a question being asked or a vote being cast. Rob Rotchell has promised there will be a public consultation exercise before the ACS takes full control of healthcare in April 2019.
- Mr Rotchell accepts that as Cornwall Council will be taking over from NHS Kernow Clinical Commissioning Group, it is accurate to describe the shake-up as “a takeover.”
- Cornwall’s health workers will continue to be employed on the same terms and conditions as they are now, working for the new Accountable Care Partnership, which will provide services commissioned by the council within the new ACS.
Asked if the council would conduct its own public consultation exercise before the ACS becomes fully operational in April 2019, Mr Rotchell said: “It wouldn’t be in our interests not to do that. So, in a roundabout way, that’s saying `yes’.”
Mr Rotchell said he understood that the secretive way the Sustainability and Transformation Plan had gone about its precursor work, leading to the design of an ACS, had increased nervousness about privatisation. “I’m not a poacher turned game-keeper,” he said. “But the talks that have been taking place between RCHT, CPFT and KCCG have not involved any private companies that I’m aware of.”
Accepting that NHS Kernow “will be coming under our auspices” Mr Rotchell promised a far greater degree of transparency and accountability than has previously been seen. “We’ve got 123 democratically elected members who will be able to ask questions and demand answers,” he said.
Mr Rotchell was not able to offer any comfort to campaigners who are trying to save Cornwall’s community hospitals. “There are two strands to commissioning,” he said. “Strategic commissioning and tactical commissioning. We’ll be doing the strategic commissioning. But the decisions about where services are delivered will remain with the provider unit.”
Mr Rotchell denied the ACS was being set up “in a rush” and thought the 12-months in shadow form would allow for a smooth transition. We will find out on Tuesday if health campaigners are persuaded.