Health campaigners vow to continue their Judicial Reviews pending clarification over ACO/ACS and Cornwall’s “Kennally Care”
25th January 2018
By Graham Smith
Campaigners trying to stop Cornwall Council’s takeover of the National Health Service are to continue their legal action, pending clarification of the definitions of “Accountable Care Organisations” and “Accountable Care Systems.”
The campaigners fear that the government’s promise to pause the introduction of ACO/ACS structures could be worthless.
Two separate Judicial Reviews are currently working their way through the courts. One has already been given permission to proceed, with a hearing on 24th April at Leeds High Court. The second expects to hear either today (Thursday) or early next week if it can also go ahead.
The litigation stems from the failure of Health Secretary Jeremy Hunt to consult on the new approach, which claims to be intended to integrate health and social care but which also fragments the NHS and exposes it to greater risk of privatisation.
Yesterday Mr Hunt said he would pause the roll-out of ACOs so that the House of Commons Select Committee could investigate their impact. But under further questioning, he failed to assure committee members of the distinction between an ACO and an ACS and the likely contracts that would govern their approach. He also appeared to blame Brexit for the lack of Parliamentary time to allow for the normal scrutiny.
Health and council officials in Cornwall now say they “currently have no plans” to set up an ACO, which is thought to carry with it an implied greater contractual freedom to commission from the private sector. But those same officials have now failed, repeatedly, to explain what changes they made to their outline business case since December 2016 when they wrote, in an internal memo, that they intended “to move with pace to set up an Accountable Care Organisation.”
Cornwall Council’s failure to publish a business case or risk assessment is fuelling suspicion that either an ACO or an ACS will mean deep cuts to community facilities.
A Judicial Review would bring clarity to any distinction and could even rule that each structure might need its own separate public consultation and scrutiny.
Cornwall Council is currently planning to set up a “shadow” ACS with effect from 1st April. As a “shadow” structure there is nothing to stop the council. But politically, to continue as if nothing had happened, would expose the ruling Liberal Democrat-Independent administration to the charge that it was even more enthusiastic than the Conservative government about such an untested and fundamental change to the NHS.
The council has still not published a business case nor risk assessment, leading many to ask why it is in such a rush to set up “Kennally Care,” named after its chief executive Kate Kennally, who would become in overall charge of commissioning healthcare in Cornwall, taking over from NHS Kernow.
Cornwall’s health and council bosses are expected to outline their response to Mr Hunt’s latest comments today.