The public seats were full at a Special Council meeting on 16th April, where Councillors unanimously passed a motion calling on Calderdale and Huddersfield NHS Foundation Trust, Locala and the South West Yorkshire Foundation Partnership Trust to withdraw their Strategic Review/Strategic Outline Case for the future of health and social care in Calderdale and Greater Huddersfield.
The Strategic Review proposals include the preferred option of downgrading Calderdale Royal Hospital A&E and turning the hospital into a small planned care clinic.
The Council motion also calls on the Council Cabinet to set up a People’s Commission to decide on the future shape and direction of travel for NHS and social care in the area, and calls on the relevant NHS authorities to provide the People’s Commissionl with detailed proposals for extended GP opening hours, the future of Tod Health Centre and other issues relating to the Strategic Review.
Members of the public who attended the meeting included Rosemary Hedges and Ken Lambert. Rosemary Hedges said,
“I’m extremely concerned at the Strategic Outline Case reconfiguration plans which I think are hasty, ill thought out and financially driven. And I’ve asked my Councillor to support the motion and want to see what the outcome is.”
Ken Lambert said,
“I’m concerned about the closure of the A&E and I’ve talked to my councillor about it. I’m hoping it remains as it is – both A&Es are overstretched. If you take one out, it’ll cause confusion and make things worse at the one that’s left.”
At the start of the debate, the Mayor announced that Councillors had unanimously accepted the LibDem revised motion as the subject for debate and that Councillor McAllister had withdrawn her motion in the interests of unanimity, since she had always been in support of safe 24 hour access to A&E in Calderdale.
The revised motion was moved by the Leader of the Council, Cllr Tim Swift and seconded by Cllr Janet Battye.
Cllr Tim Swift said that since the proposed NHS changes had been made public, a huge amount of debate and discussion had linked the proposals to national NHS policies, but he wanted the focus of the Council debate to be on local issues, since the common ground was that these proposals are wrong and lead in the wrong direction.
He wanted the withdrawal of the proposals not only because they’re wrong but because we also need a new way of talking about the future direction of the NHS, that takes account of the public strength of feeling and sense of ownership of the NHS.
Cllr Swift said we must not dismiss concerns about the NHS that the case for the Strategic Review identified – like increasing demand for NHS care, decreasing resources and changes to medical technologies and drug treatments. But we can question whether the Strategic Review’s proposals for dealing with these issues are right – for instance, their proposals for dealing with acute and emergency hospital care.
He said that the proposals for replacing acute and emergency hospital care with a new system of integrated health and social care were the weakest element of the Strategic Outline Case, and that,
“We are being asked to take a leap of faith into the unknown, at great speed.”
Cllr Swift said that he also questioned the Strategic Review’s model for delivering change, which he described as “fundamentally a top down approach”. He said,
“In all the talk of engagement and consultation, real trust and dialogue have been lost.”
He said that a People’s Commission would respect the skills and knowledge of healthcare professionals but would allow the public and patients a voice. Membership of the Commission would be on a cross party basis.
In the discussion that followed, a number of themes emerged.
Calderdale Royal Hospital needs to keep its A&E and acute services
All Councillors were united about the need for Calderdale to keep its A&E and acute services.
Cllr Wilkinson said that both A&E Departments were struggling to meet targets, and:
“Only a fool would think that the best way to solve the A&E crisis is to close an A&E Department.”
A LibDem Councillor said that similar proposals had been sold as a golden bullet in East Lancashire but they have resulted in services going into special measures as A&E can’t cope.
Councillor Carter said that the NHS Trust had chosen not to speak to other service providers, like transport, but that specialist services were getting further and further away and that caused problems for patients to have visitors, which was an important part of healing.
Cllr Jennie LInd paid tribute to people involved in the campaign to save Calderdale A&E which she said had made a tremendous difference and the powers that be were recognising they had to listen. She said she wasn’t against change but she wasn’t prepared to see our expensive new hospital downgraded to a clinic.
Many other councillors spoke of the importance of keeping Calderdale A&E and all the other facilities at CRH.
Frustration with the Trust, Commissioning Groups and confused local NHS governance
Several Councillors expressed frustration at the unprofessional and undemocratic way that the Calderdale and Huddersfield NHS Foundation Trust and the Clinical Commissioning Groupss had acted in preparing and publishing the Strategic Review/Strategic Outline Case.
Cllr McAllister said that she embraced what Cllr Swift had said and condemned the unprofessional nature of the Trust’s proposals. But she went on to say that the original Labour motion had failed to highlight the role of local councillors in the Strategic Review, and that,
“Both leaders have blood on their hands.”
She added that Labour had stirred up scaremongering and created a hornets’ nest as a pre-election tactic.
Cllr Adam Wilkinson said that Cllr McAllister was on the Adult Health and Social Care Scrutiny Panel and knew that Councillors had only seen the Strategic Outline Case presentation and the National Clinical Advisory Team Report in February, even though the NCAT Report dated from June 2013 and accurate rumours about its key contents had been circulating since October.
Cllr Baines said he was happy to support the motion but it didn’t have any clout.
“I know we can advise, but we don’t have any authority. If change is justified, you should be able to justify it to the people. So I hope that the bodies that do have the power to make changes listen to us. The main thing is that we have a first class NHS.”
Cllr Raistrick said he was glad to see unanimity breaking out and that,
“I do condemn the unprofessional way in which the Strategic Review has been done.”
He questioned Dr Brook’s ability to run a commissioning group with a £260m/year budget. There was no costed business plan and the figure for £50m savings had been plucked out of thin air and was a completely made up number.
“I’ve thought for some time that the decision’s already been made – and the new Thompsons Local lists only one hospital A&E and that’s not in Halifax.”
At this, there were loud gasps in the Council chamber. However, after the meeting, members of the public said that this was the case last year too and that there is just one organisation, the Calderdale and Huddersfield Hospital Trust, so it’s no surprise if calls to A&E are handled through one number.
Cllr Sutherland said,
“When we’re condemning the Trust, it’s a case of ineptitude not a conspiracy. What I hope we can get out of a People’s Commission is a better way of providing health and social care in Calderdale.”
Cllr Jayne Booth said the CCG had been railroading the Adult and Social Care Scrutiny Panel and had treated it “appallingly”. She said no reason had been given for the preferred option and that it must have been the result of an “ip-dip” moment.
Cllr Bob Metcalfe said,
“All the way this has gone through has been a bit of a shambles. Having a preferred option makes any consultation meaningless.”
Cllr Stout said it was time to decide what to do with CCGs and Trusts nationally and locally. He said,
“We have a lot of unelected people. We have too many unelected experts telling us what we need. We are too top heavy with administrators in the NHS. After the election I hope we can go back to root and branch of what we’re trying to provide – it’s everyone’s NHS and we need local elected people in control.”
He said they would fight to keep Calderdale A&E open and all the other facilities at CRH, or else a private healthcare company would come in and sell us back our own services.
Summing up at the end, Cllr Tim Swift said that the fundamental strength of the motion was that it dealt with the confused governance of the NHS.
He also said that it was simply not correct for Cllr McAllister to say that councillors had any role in drawing up the Strategic Review proposals.
Health and Social Care Act and austerity politics
Cllr Pauline Nash said she was here to look at the issue of how the proposals would affect older citizens, many of whom have more than one serious illness. She said,
“The Strategic Review proposals are not a leap of faith, they’re more like a pig in a poke.”
She said that GP services are suffering the effects of years of underfunding and with increased demand, GPs are at breaking point. The Government has agreed an extra £250m a year for GPs but this probably isn’t enough to look after older patients. Cllr Nash continued,
“GPs are often making more than 60 patient contacts a day, over several days. The system will implode if more GP funding isn’t available on a sustained basis. 94% of NHS Trusts are in a precarious position. In the midst of this the CCG has proposals for cutting hospital care. I obviously support the motion.”
Cllr WIlkinson said he wasn’t going to talk about the Health and Social Care Act because he didn’t want to get into a blame game.
But Cllr Barry Collins said,
“Everyone accepts that the Strategic Outline Case has been badly handled, but let’s not blame the CCG and the Trust. It’s not their fault. They didn’t bring in the Health and Social Care Act or the Care Bill which allows hospital closures. They’re trying to respond to NHS funding cuts and a blizzard of reports like the Keogh Report calling for drastic action.”
Cllr James Baker said he was pleased to see consensus building, and went on,
“NHS problems are huge and all parties bear some responsibility. There’s a funding freeze, rising costs of treatment and increasing questions about how much money we should spend and how we should spend it.”
He said he supported more funding for the NHS and that the LibDem motion had been to get assurances from the Council Leader about involving people and he was pleased to have got those assurances.