By Julia Penhaligon
Labour Party leader Jeremy Corbyn will today (Monday) try to slow the “Kennally Care” takeover of Cornwall’s NHS, with an obscure Parliamentary tactic designed to halt the national roll-out of Integrated Care Provider contracts.
The government is attempting to break-up the NHS into small, local contracting units previously known as Accountable Care Organisations. It is doing this without Parliamentary scrutiny and has introduced a Statutory Instrument (known as SI 248) intended to amend the way GPs are contracted to provide primary care. If the government succeeds, the Statutory Instrument will come into force on 1st April.
The Cornwall version of this ICP involves a contract with a private, not-for-profit company called Kernow Health. Kernow Health is a community interest company, regulated by the Department for Business, Innovation and Skills rather than the Department of Health. Private charities, such as Volunteer Cornwall and Age UK, are also involved. They are regulated by the Charity Commission.
Critics of ICP contracts, and the Shaping Our Future model of how Cornwall’s health service is to be organised, believe it opens the NHS up to even further fragmentation and privatisation. Some American companies have already expressed interest in bidding for GP contracts in England.
The ICP model also allows local commissioners to abandon traditional national standards for minimum levels of care, and poses unanswered questions about what happens if those commissioners run out of the money towards the end of their fixed-term budgets.
Some Cornwall councillors, however, are enticed by the prospect of strategic commissioning decisions being taken at County Hall, which they consider to be more democratic than existing NHS governance arrangements. Because Cornwall Council’s chief executive is set to become the lead health commissioner, the model has become known as Kennally Care.
This afternoon Mr Corbyn, supported by other Labour MPs including Shadow Health Secretary Jonathan Ashworth, will present a “humble address… praying that the Amendments Relating to the Provision of Integrated Care Regulations 2019 (S.I., 2019, No. 248), dated 13 February 2019, a copy of which was laid before this House on 13 February 2019, be annulled.”
So-called “prayer motions” are unusual – the last time one was attempted was 19 years ago – and without the support of at least some Conservative MPs the motion is unlikely to succeed.
But the move is a clear signal that the Labour front bench now has an alternative vision of how healthcare is to be provided. Labour Party policy is now to “Re-instate the NHS” and abandon the “purchaser-provider” private contracts which have been dominant for the past two decades.
Recent reports by the National Audit Office and the Nuffield Trust say there is no evidence that the ICP model would meet the intended aims of reducing costs and improving quality of patient care.
The Chair of the British Medical Association has also told GP members they “should not feel pressured into entering an ICP contract as to do so could leave their patients worse off.”
Because of the lack of any primary legislation, health campaigners are currently waiting for a date to challenge the legality of the Kennally Care model in the Supreme Court.
The government aims for Integrated Care Provider systems to cover the whole of England by 2021.