Government to offer Cornwall “debt write-off”….

Government to offer Cornwall “debt write-off”….

…..worth millions if council agrees to NHS takeover

10th December 2017

By Graham Smith

Councillors are preparing to launch a “charm offensive” in a bid to win the battle for hearts and minds over the future of Cornwall’s health service. Cabinet members have told Cornwall Reports they have been stung by criticism from members of the public, alleging that council plans to take over the NHS in Cornwall will lead to wholesale privatisation and worsening standards of care.


Nearly 150 protestors marched through Liskeard yesterday (Saturday) to declare their opposition to plans for an Accountable Care Organisation, which cabinet members are being urged to vote for at a meeting on 7th February. The ACO will transfer responsibility for health care from Whitehall to Truro, giving Cornwall significant new freedoms to run its own affairs.

According to the current timetable, the ACO is due to be created in shadow form in April and to then take operational, day-to-day control of healthcare from April 2019. It will replace NHS Kernow, the Royal Cornwall Hospital Trust and the NHS Partnership Foundation Trust, and will be led by Cornwall Council’s chief executive Kate Kennally.

The most likely “democratic” element appears to be the Health & Wellbeing Board, currently chaired by council leader Adam Paynter. In some respects, the ACO would resemble the former Cornwall & Isles of Scilly Health Authority, which existed from 1974 until 2002. But a major difference would be the fixed, “place-based” budget and increased local discretion to “purchase” care from the private sector. There are currently no details about what happens at the end of the budgetary cycle. The “accountable” part of any ACO has still not been agreed.

Senior councillors have been unnerved by a volley of letters, telephone calls and emails protesting that the move is reckless and will lead to the break-up of the “National” Health Service.

“We weren’t ready for this,” one cabinet member told Cornwall Reports. “Several people have asked me why I’m trying to take over the NHS. The truth is, I don’t want to take over the NHS. I love the NHS. It’s the best system of healthcare in the world.

“We need to get out there and sell our message. We are losing the communications war. We’ve got to explain that the ACO will be funded from central taxation and that healthcare will still be free to anyone who wants it. It will just be a bit more Cornish. And we should explain that that’s a good thing. But in the future we will have to do it with considerably less money and I don’t really understand how we’re going to do that.”

Three cabinet members have told Cornwall Reports they were unimpressed by a faltering performance by their leader, Adam Paynter, when he was tackled about the subject on local radio last week. “We need some good news facts and we need them now,” said one. “At the moment we sound like we don’t know what we’re talking about – which is true, we don’t. I’ve got some idea, but nothing like the detail I need. I can’t sell it if I don’t know what it is.”

One of the first eye-catching announcements expected in the next few weeks is that if the council agrees to set up the ACO, the government is prepared to write off Cornwall’s existing healthcare “debt” – a theoretical construct stemming from the NHS internal market, and which on some assessments means Cornwall is nearly £100 million “overdrawn” at the Treasury.

Cornwall Council’s attempt to set up an Accountable Care Organisation brought nearly 150 people to the streets of Liskeard yesterday, in a colourful and noisy protest organised by the Labour Party. Photos by Leah Browning.

But this reshaping of the “balance sheet” will not be enough to save Cornwall’s community hospitals, and councillors have been shaken by news of a legal challenge to ACOs, which is supported by leading academics such as Professors Allyson Pollock, a doctor, and Stephen Hawking, the celebrated physicist.

“Please don’t put me in a room and expect me to argue the case against either of those two,” said the cabinet member. “Let me be clear, I am not in favour of increased privatisation of the health service. I don’t want to break-up the health service. But is there anything I can do to stop it? Probably not. And I think that is true whether we set up an ACO or not.”

It now looks certain that Ms Kennally will miss her target date of 7th February for the council’s cabinet to set up the ACO, as dozens of councillors are now demanding that the full council should take the final decision, at a separate meeting only a week later.

“It will go through, no doubt about it,” said the cabinet member. “The Tories are really up for it – much more so than our lot and the Tories are the largest party. I think there’ll be a free vote and at the end of the day, only a dozen or so councillors will vote against. But if we make it a free vote then hopefully people won’t blame us if it all goes horribly wrong.”

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