Public+services+-+health+services+-+Local+campaigns+-+Laurels+Full+Statement

Supported by the Stop Haringey Health Cuts Coalition
- SUSPEND THE TENDERING / PRIVATISATION ** - SUSPEND THE MOVES TOWARDS TURNING THE LAURELS HEALTHY LIVING CENTRE INTO A ‘NEIGHBOURHOOD HEALTH CENTRE’/ POLYCLINIC ** 1. The tendering / threat of privatisation of the Laurels PMS GP Surgery 2. The PCT’s plans for the transformation of the Laurels Healthy Living Centre into a ‘GP-led Health Centre’ / polyclinic 3. The fact that the PCT’s plans transgress the constituted ‘Heads of Agreement’ and aims of the Laurels Healthy Living Centre (which is owned by Haringey Council in trust for the people of the NDC Bridge area) - Insist that the tendering process be suspended - Insist that the PCT consult adequately with patients and public about their proposals for the PMS practice and The Laurels before any further action - Declare that proposals for The Laurels amount to a ‘substantial variation’ of services - Convene a full meeting of the Committee to further consider this matter, including the special legal status of The Laurels The powers and duties of the Committee to intervene over local health issues were set out in the __Cttee__ __Chair’s (Cllr Bull) Report to the Cttee, 6th October__ (Agenda Item 8, paras 5.10 - 5.15). See Appendix 1 Para 5.10 sets out the ‘general duty’ to consult with patients and public which the PCT recognises it must do regarding The Laurels. But para 5.10 also sets out the triggers for the use of Cttee powers regarding ‘substantial variation’ and ‘substantial development’ of services. The PCT’s plans for turning The Laurels into a Health Centre clearly fall within the ‘substantial variation’ bullet points in 5.10: - ‘Changes in accessibility eg reductions or increases of services on a particular site or changes in opening times for a clinic’ //[as is proposed at The Laurels]// - ‘methods of service delivery eg moving a particular service into a community setting rather than being hospital based ’ //[as is proposed at The Laurels]// Indeed the Committee on 2nd June specifically ruled (at para 5.11) that the closure of a ward at St Ann’s Hospital was a ‘substantial variation’ to services, and hence subject to a statutory consultation process, due to   - ‘the number of patients potentially affected’ and as the proposal ‘involves moving a significant proportion of services from a hospital setting into the community’. //[as is proposed at The Laurels]// Conclusion 1 The proposals for The Laurels are a clear ‘substantial variation’ – but even if they weren’t, the Committee must scrutinise if adequate, timely and effective consultation has taken place with The Laurels patients and users.   1.1 We are implacably opposed to private companies and corporations taking control of our healthcare, and in particular our GP surgeries.*** This is a highly controversial and fundamental threat to the public service ethos of the NHS, which has done us proud over the last 60 years. Privatisation of many other public services has tended to be a costly disaster and, considering the current economic crisis, extremely foolish. There is no justification for this move which the PCT, as manager of this particular practice, is under no obligation to implement. Instead they should be working with the community and Council to challenge the Government rather than slavishly following policies which damage healthcare and the NHS.** * We support Doctors running their own practices. Anyone, like some members of the PCT Board, who have stated that there’s ‘no difference’ between a local Doctors’ Partnership and a Multinational Corporation running a surgery as ‘they are both companies’ should be considered unfit for public office. In addition there is clearly no level playing field for bids from the local Drs competing with big business. For this to be the case there should be full financial help (it may cost up to £30,000 to put in a bid) and advice to them from the PCT, and criteria set which are favourable to the local Drs and their proven commitment to patients’ welfare and quality of service rather than to shareholders’ profits. 1.2 Whatever the views of the people in this room are about the issue, the tendering should be clearly unacceptable to this Committee in its statutory role as Scrutineer as there was no opportunity for patients to give THEIR views. There was simply no patients’ consultation at all about this. As the PCT admit in their report to this Committee (see p5 of the Report – ‘Consultation’ pt 2), the first contact with patients about this issue was at the end of October, after the tendering had already started. This should be enough to halt the tendering process and demand some effective consultation before any further action. However the failure to consult was //much// worse than that, as the attached __Laurels PMS Practice ‘Consultation’ Dossier__ proves. See Appendix 2 The Dossier was compiled by the Patients’ Representative (Dave Morris) on the official Laurels PMS Practice Patient Participation Group and sets out the auditable trail of failure to consult at every stage over the last year. - The tendering threat was kept secret from patients despite numerous opportunities to inform all patients in the previous 12 months (the letter to all patients last winter asking for opinions re Dr Alex moving from the PMS Practice to the Medical Practice, the bi-annual Newsletters, a widely distributed Patients Questionnaire etc) - The PMS Patients’ Rep was not consulted, despite raising concerns about ‘rumours’ in March ’08. - In June 2008 James Slater, PCT’s Head of Procurement, in answer to concerns expressed by Cllr Bob Harris (Cabinet member for Adult Social care & Well Being), wrote: //‘ …// // we are // // planning for consultation in September 2008 ////, with the procurement process running from October to December 2008’. // This consultation was clearly to take place BEFORE the tendering. It scandalously never took place. - On October 6th, the O&S Cttee was seriously mis-informed that: //‘The TPCT intends to consult with patients and other stakeholders during October. In addition,// // all patients registered with the practice have already been written to //// advising them of the intended change in service.’ // No patient we’ve spoken to can recall any such letter, and as the PCT’s own consultation summary demonstrates, this was not true and seriously misled your Committee on a fundamental matter. - A PCT letter was sent to patients at the end of October publicising some ‘consultation’ meetings at The Laurels on 28th, 29th and 30th October. The letter is worthless as a consultation document for the following reasons: o Patients could not have received them in time. It seems that most, if not ALL, were posted out //after// the deadline (17th Oct) for sending back the form to request a place at the ‘restricted’ meetings, and many arrived even after the actual dates of the meetings. [See attached letter – dated 22nd Oct, postmarked 27th Oct, arrived 29th Oct.]. Many patients (of those very few who were somehow present at the meetings, or who contacted us later) complained bitterly about this, and on 30th Oct James Slater had to publicly acknowledge to the meeting that this had been badly mismanaged. o Inadequate information was given, and no relevant question was asked. The letter is a general one about informing patients //‘in order to improve access and enhance the services provided’// at The Laurels. It only briefly refers to ‘seeking new providers for the laurels PMS practice’ and ‘an advert’, wholly failing to explain what this means or its significance. Despite that, and also saying that the coming meetings were to seek patients’ views ‘to help shape healthcare for Haringey’, the enclosed ‘FAQ’ and Patients’ Questionnaire failed to mention tendering issues at all. The full documentation is contained within the Dossier. Conclusion 2: The Committee has the duty and power to insist on the suspension of the tendering process and that adequate consultation be carried out first. 2. 1 The proposals to extend opening hours, bring in a range of additional services from hospitals, and generally develop a new model for Primary Care in Tottenham etc clearly constitute a ‘substantial variation’ as set out in Cllr Bull’s Report on Oct 6th (quoted above under ‘Committee’s Powers’). Indeed the Committee has already ruled that the PCT’s proposed ‘10 year Strategy for Primary Care in Haringey’, focused around polyclinics/health centres constitutes a ‘substantial variation’ – one that concerns you greatly, and that you are keeping open your option of exercising your power to refer this to the Secretary of State, pending further investigation/evidence. 2.2 Such a model, which has been floated by the PCT for the whole borough - is extremely controversial - is supposed to be undergoing extensive public consultation before amendment, rejection or implementation - the Committee has already expressed concern about the pressure for relocation of neighbourhood-based local GP surgeries into Health Centres, and the lack of detail in the 10 year plan - the Committee has already expressed a great deal of concern whether adequate finances are available. It is shocking that Haringey PCT now admit (PCT Report to O&S Ctte, 4.11.08 – para 2) that //‘As Haringey is not considered to be under doctored// // no new monies were allocated to Haringey //// with the cost of the development and other associated service developments being funded locally from PCT resources’. // This is despite both the Government’s Health Secretary (June 8th) and ‘Healthcare For London’ architect Lord Darzi (July 6th) stating categorically*** that such developments will be additional to existing services and accrue additional funding.** * Government Health Secretary Alan Johnson stated on June 8th: //'No current GP practices will be closed, as the new services will be in addition to existing ones and come with extra money.'// [Article by Alan Johnson published in The Observer on Sunday June 8th]. “//We are talking about 150 new health centres across the country..... This is additional money, this is not replacing current practices."// Asked whether surgeries would close, Lord Darzi said: //"Absolutely not. This is additionality.'// [Lord Darzi - Interviewed on BBC1's Andrew Marr show, July 6th] 2.3 The Laurels is far too small to cope with the planned-for expansion of patients and services, especially as other community-based health and well-being projects are entitled to operate and flourish there (see 3.1 below). Indeed, the transformation of a Healthy Living centre for a wide range of health and well-being purposes, into a large PCT-run waiting room for people awaiting appointments (for GPs and blood testing) is unacceptably already undermining the character of the Centre and the viability of other less formal community services, such as the café. Conclusion 3: The Committee has the duty and power to insist on the suspension of the development of The Laurels Healthy Living Centre into a Health Centre / polyclinic until a comprehensive financial analysis of the borough-wide strategy has been conducted and shared with the Committee, an effective and honest borough-wide consultation has been completed and brought back to the full O&S Cttee for scrutiny, and an enquiry has been conducted into the legal status of The Laurels and implications for its services and projects. 3.1 The Laurels Healthy Living Centre was opened in June 2004, paid for by the New Deal for Communities with a large chunk of their £50m 10 yr regeneration funding (£3.85m). As the NDC Board had no legal status Haringey Council signed the head lease on the NDC’s behalf. It is constituted as a Healthy Living Centre to include and subsidise a range of health and social well being projects for the local community, such as complementary therapies, advice, café etc. The unusual capital expenditure and set up was only agreed and supported by the Government Office for London on this basis alone. The rental income from the hire of some of the space (for example to the PCT for 25 years only) is around £285,000 pa. See Appendix 3 3.2 As stated above the purpose of this money is to subsidise the aforementioned health and social well being projects. However, these projects in The Laurels have unaccountably been allowed to whither (See Appendix 2, p5 ‘AOB’) – the £286,000 annual rental income is there to support such projects. In contrast the NHS services have been allowed to expand (eg the recent addition of blood testing moved from St Ann’s Hospital), against the spirit and letter of the Heads of Agreement signed by D. Lammy MP and Cllr Adje. This matter must be investigated by the Committee, both as it constitutes a ‘substantial variation’ in health services, but also as it violates the spirit and letter of the Agreement by which the Centre was set up. Conclusion 4: The Committee, as the appropriate body of the Council, must insist on the suspension of the development of The Laurels Healthy Living Centre into a Health Centre / polyclinic until an enquiry has been conducted into the legal status of The Laurels and the implications for its obligation to provide various other services and projects. __  The Laurels Action Group includes many patients, plus reps from the medical practice, the official Laurels Users Group, many local residents associations, and community groups. c/o 38 Clarence Rd, N15 simon@cnra.org.uk ** Appendix 2 ** LAURELS PMS PRACTICE ‘CONSULTATION’ DOSSIER Pages enclosed Subject 1. PMS Service Manager Letter to DM, 9.01.08 2-3 Sept 07 Newsletter 4-8 PMS Service Manager email to DM, 10.01.08 · // See p 5 para 1, re letter to all patients – tendering not mentioned // · // See para under AOB showing failure to support well-being services // 9. DM notes from PPG meeting, 31.3.08 · // See X – ‘tender.. not started yet… looking into it – a probability’ // 10-17 PMS Service Manager Letter to DM, 19.05.08 - plus enclosures · // Next meeting – September // · // DM ‘Patient Rep’ // · // ‘Mid/long term plans’ for alternative organisation. DM replies ‘no patient consultation’ yet. Extra sentence added [p12, under pt ‘5’] presenting tendering as a fait accompli. //  · // P16-17 Patients Questionnaire – no relevant Q re tendering // 18-20 Letter from Cllr Bob Harris to DM, quoting J. Slater (p19): //‘planning consultation in Sept, procurement Oct-Dec’// 21-25 ‘Consultation’ Letter for meetings, posted 27.10.08 for patients to reply by 17.10.08
 * Presentation to the Haringey Council's Overview & Scrutiny Committee **
 * Thursday 13th November 2008 **
 * WHY THE COMMITTEE MUST EXERCISE ITS POWERS TO: **
 * OF THE LAURELS PMS GP PRACTICE **
 * THE 3 KEY ISSUES FOR THE O&S COMMITTEE MUST CONSIDER AND RULE ON **
 * WHAT WE’RE ASKING THE COMMITTEE TO DO (reasons on the next page) **
 * THE COMMITTEE’S POWERS **
 * THE 3 KEY ISSUES **
 * 1. The unacceptable tendering / threat of privatisation of the Laurels PMS GP Surgery **
 * 2. The PCT’s plans for the transformation of the Laurels Healthy Living Centre **  into a ‘GP-led Health Centre’ / polyclinic
 * 3. The fact that the PCT’s plans transgress the constituted ‘Heads of Agreement’ and the  Aims of the Laurels Healthy Living Centre – as guaranteed in law by Haringey Council  **