The National Health Postcode Lottery / A Humanitarian Disaster. (567)

To the Health Secretary:
For Clarity - Attempt 567.

567) The National Health Postcode Lottery / A Humanitarian Disaster.

Dear Mr Hunt,

Surrey, the Sweetheart Capital of England appears to have done a behind the scenes deal with the Treasury to avoid a referendum on a potential 15% hike in the area's council tax in order to pay for the growing cost of social care..

Plymouth, on the other hand has far few leafy suburbs and well-healed residents. Here the proposed increase in council tax bills to pay for social care is likely to have a far greater impact on its residents than Surrey's. As a consequence Plymouth is likely to see more social dislocation and yet more inequality.

How can this be right in a country which has just taken back control?

Yesterday's Herald told us that the annual bill for Plymouth City Council and CCG was £400 million.

In 2015-16 both South Devon and Torbay CCG and NEW Devon CCG were rated as, "Inadequate" by the regulator Monitor. The inadequate South Devon CCG - without any meaningful consultation - has just announced its intention to close 32 acute care beds and transfer maternity services from Torbay Hospital to Plymouth's Derriford Hospital.

The AA route planner tells expectant Torbay mothers to expect a 52 minute 42.3 mile drive. If that's not a future humanitarian crisis I'm not sure what is. Humanitarian is a word that many Conservatives seem to struggle with.

The Express and Echo's Colleen Smith reported that the Chief Operating Officer, Liz Davenport, was making these decisions due to a £35 million black hole in the budget which was expected to rise to £300 million by 2020.

The Chief Operating Officer believes now is the right time to cut those 32 acute beds.

Mr Hunt, The Vale of York CCG also decided to cut services. Isn't Dr Richard Vautry, Deputy Chair of BMA's GP Committee, right when he says;
"I'm concerned that NHS England has approved these proposals to effectively ration services as a method of cost cutting, but dressing it up on clinical grounds.

There is further evidence of a postcode lottery with care simply being based on an area's ability to fund services, rather than the real clinical need consistently applied across the country."

CCGs are, to all intents and purposes, largely unaccountable to the public. Unless something is done about them they will become the Fragmented Health Service of the future.

When Parkinson's UK made Freedom of Information Act requests to all of England's CCGs in an attempt to discover how NHS funded nursing care were being arrived at, many commissioning groups simply didn't respond.

When I made a Data Protection Act request to Livewell Southwest Ltd not all the information I asked for was provided.

There is no national databank on how CCG's arrive at decisions regarding who should pay for the full cost of nursing care - the state or the individual. Or who within those organisations arrives at those un-collated decisions. Or if some CCGs interpret the National Framework for Continuing Healthcare and NHS Funded Nursing Care more fairly and justly than others.

Plymouth's Livewell Southwest Ltd do not the explain the medical grounds upon which they base their decisions. Anonymous individuals just present the sick, the elderly, the dying and dead - with a bill.

How can that right either?

What chance does the individual have when requesting information on how their loved ones have been treated by anonymous decision makers? None. Unless they employ the services of a solicitor or advocate.

The BMJ tells us - alarmingly - that,
"Our survey showed a wide variation in CCGs' size with CCG population coverage varying from 90.000 to 855.000 and member practices ranging from 10 to 110. In 2013 the Office of National Statistics released CCG population figures based on the national census ranging from 61.600 in Corby to 863.400 in NHS NEW Devon."
(www.ons.gov.uk/ons/rel/sape/clinical-commissioning-group-population-estimates/mid-2011-census-based)

Perhaps, that in part, helps to explain NHS NEW Devon's "Inadequate" rating. Their accountability to individuals most certainly is.

Importantly, in terms of accountability and democracy, the BMJ reports states,
"The lack of uniformity in CCG structure and the lack of clarity over the meaning of membership raises questions over accountability, which becomes of greater importance as CCGs are taking over responsibility primary care co-commissioning."

Imagine the barons of medieval times jostling for power and prestige and it'll give you some idea of what CCGs are about.

Q. Mr Hunt, when organisations like Livewell Southwest Ltd hand a patient of theirs a one-line decision regarding their entitlement - or lack of it - to NHS funded nursing care is this a way of shifting the cost of care from the state onto the individual and is this not an informal form of income tax?

Yours sincerely,
Steve Gilbert.

The Ombudsmans61percent campaign is at :www.blogger.com