EXCLUSIVE: The worldwide web of private consultants with secret plans to re-draw the map of Cornwall’s National Health Service

EXCLUSIVE: The worldwide web of private consultants with secret plans to re-draw the map of Cornwall’s National Health Service

20th August 2018

By Graham Smith

Health chiefs have hired more private sector consultants to help them close down and sell some of Cornwall’s community hospitals, Cornwall Reports can reveal.

With formal consultation yet to start about the future of hospitals at Saltash, Fowey and St Ives, newly released Freedom of Information answers have confirmed that the struggling Capita group is behind the secret plan to transform Cornwall’s health estate.

The plan is called the NHS Kernow CCG Local Estates Strategy and has been in “draft” form for two years.  There is still no publication date and NHS Kernow has refused to release the draft documents, claiming an exemption under FOI legislation.

Officials at Cornwall Council, who also hold copies of these documents, have also refused to share the information.  A council statement said: “In order to deliver a fit for purpose property estate which meets the needs of the health services in the future, the NHS is highly likely to require investment into its property estate.

“To fund that investment it will need to leverage the value of its existing property assets. If these draft reports are released to the public domain, the ability of the NHS to negotiate commercial property deals which realise maximum value would be prejudiced.”

Separately, the Royal Cornwall Hospital Trust has hired the Japan-based Kajima group to advise on a document called the “Cornwall and Isles of Scilly Estates Strategic Outline Case.”

The council says it will not release the documents it holds because they could be “misinterpreted.”

Kajima is a PFI specialist with worldwide interests.  Its Tokyo HQ was recently raided by Japanese prosecutors investigating alleged anti-Trust violations and conspiracy to rig markets.  Capita is best-known for its outsourcing activities.  The main Capita group recently had to raise more than £700 million through an emergency rights issuebecause of concern over its rising debt.

The involvement of Capita and Kajima in determining the future of Cornwall’s cottage hospitals comes on top of decisions to hire Price Waterhouse Coopers to produce a £560,000 Sustainability and Transformation Plan (STP) report branded as “not fit for purpose” by Cornwall Council; and an £87,000 report by the Chicago-based GE Healthcare Finnemore which advocated a range of bizarre ideas, including a single Health Commissioner for Cornwall, outside of the National Health Service.

Cornwall Reports understands that GE Healthcare Finnemore is continuing to advise the Shaping Our Future partnership, which has taken over from the STP.

The costs of the Capita and Kajima involvement will now be the subject of further FOI questions.

NHS Kernow has consistently denied that it has already decided to close any community facilities.  But the facts on the ground point to the permanent loss of Minor Injury Units at Saltash and Fowey, and the subsequent closure and eventual sale of those hospitals.  The Edward Hain hospital at St Ives has now been closed for more than two years.

There has been no public consultation and NHS Kernow is acutely aware that the organisation risks Judicial Review of its process.  Public consultation is supposed to come before hospital closures, not after.

NHS Kernow describes all of the hospital closures as “temporary” but the different justifications for the loss of service – fire risk (Edward Hain), staff shortages (Saltash) and hygiene issues (Fowey) – could have all been resolved within weeks had the health bosses not already decided to re-draw the map of Cornwall’s community facilities.

The Local Estates Strategy document has so far been seen by only a handful of unelected officials, including some at Cornwall Council.  The draft report has never come before any formal, open meeting of Cornwall Council’s Health & Adult Social Care scrutiny committee – leading to concern that County Hall has been failing in its role as a supposed guardian of the public interest.

Last year the government told local health chiefs they had to sell hospitals to fund care.  Councillors have not challenged the political assumptions underlying this approach.

The estates strategy is now particularly sensitive given the enthusiasm of the Shaping Our Future partnership to carve Cornwall into three distinct units – West Cornwall, Mid Cornwall, and North and East Cornwall, each with its own “leadership team,”  raising the prospect of even more chief executives in an already fragmented NHS.  The SOF chair, Kate Kennally, who is also chief executive of the council, said these plans now needed to progress “at pace.”

Cornwall Reports asked for a public interest justification of the secrecy and invited Cornwall Council to publish the documents it holds and which have been seen by senior officials.  The council refused.  This is the full council statement justifying its refusal: “The community hospitals review is still work in progress and although no current date for finalising this work, the reports would be published once this work is finalised.

 

“We have made no decisions” – NHS Kernow insists the future of St Barnabas hospital, Saltash (above), Fowey hospital and Edward Hain hospital, St Ives are still up for discussion

“Although this is likely to be still some time away and in 2019 at the earliest, the Council has decided that this information should be withheld from disclosure to you pursuant to the provisions of Section 22 (future publication) of the Freedom of Information Act (“the Act”).

“As Section 22 is a qualified exemption, a public interest test has been applied. The Council has concluded that the public interest test favours non-disclosure. The reasons for disclosure and non-disclosure of the information have been considered.

“Disclosure of this information would be in keeping with the Council’s ethos of being open and transparent and in this case, specifically in relation to investigations which have been undertaken into the current status, utilisation and options for future provision of publicly owned property assets.

“Conversely, the reasons for withholding the information have been considered. These reports and the estates strategy are discussed as part of the wider Shaping our Future discussions and meetings in relation to work being undertaken on the shape of future health provision. Therefore, these reports will contain options that are being considered as part of a formal process of consideration and consultation that will take place at an appropriate stage. Releasing information at an earlier stage, outside of the current formal process may lead to information being misinterpreted by the public, or the publicising of options that may not be taken forward, especially given that the estates strategy is intrinsically linked to the wider shaping of service provision and this is still under discussion as part of the Shaping our Future/STP discussions.

“Additionally, in order to deliver a fit for purpose property estate which meets the needs of the health services in the future, the NHS is highly likely to require investment into its property estate. To fund that investment it will need to leverage the value of its existing property assets. If these draft reports are released to the public domain, the ability of the NHS to negotiate commercial property deals which realise maximum value would be prejudiced and the overall strategic interests of the public (i.e. to have fit for purpose properties capable of supporting future models of health care) would be harmed.

“Therefore, in conclusion, we are of the opinion that the balance of public interest favours non-disclosure of this information at this time.

“Please note however that the wider programme has and will be subject to public consultation as and when appropriate. Any information in relation to the community hospital estate would be shared as appropriate as part of these consultation rounds.

“Where the estates strategy is discussed as part of the wider Shaping our Future discussions and meetings, these would appear in the relevant Board meeting minutes, or published as specific documents if relevant and would be found using the following link: http://www.shapingourfuture.info/”

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