Our elected representatives on local Councils are the only piece of democratic accountability in the CCGs “Integrated Care System”
John Whalley, KONPNE Steering Group member and retired nurse
Ever had that feeling that you’ve asked someone a crucially important question (one which means the difference between life and death), and you’ve been fobbed off with nebulous platitudes of empty nothingness? The response from Cllr Margaret Hall (Chair, North Tyneside Council Health and Wellbeing Board) to last weeks formal question from Keep Our NHS Public North East was totally underwhelming.
Two years ago, in March 2018, North Tyneside Councillors unanimously and impressively passed the motion that“we agree to oppose any proposal to implement the delivery of healthcare in North Tyneside via an ACO / ICS, a project which in North Tyneside CCGs own report was stated to be high risk”. (1)
In North Tyneside, we clearly had a Council to be proud of; a positive force to be reckoned with in standing up against NHS England’s and local CCG’s plans to railroad through a health system which will ultimately lead to increased privatisation and the demise of the NHS. This system, originally known as “Accountable Care” and subsequently rebranded as “Integrated Care Systems”, is imported from the United States where healthcare is privatised, underpinned by health insurance, and is definitely NOT equitable, accountable, or available to all in need.
So, fastforwarding to 2020, where are we now? Sadly, it seems, in downward spiral. Over the intervening months, KONPNE became increasingly alarmed by a number of reports in Council minutes which, seemingly, indicated a softening of approach and a warming to the demands of NHS England and the local CCG.
At the full Council meeting on 16th January 2020 (2), Dr Helen Groom, retired GP, local resident and member of KONPNE formally asked the following two questions on behalf of Keep Our NHS Public North East: Initial question:“What evidence does North Tyneside Council have that members have opposed or even raised objections to the ICS? In becoming part of the ICS, what safeguards have you obtained on behalf of North Tyneside residents to ensure services will not be privatised?” Supplementary question:“Given that North Tyneside Council appear to be in equal partnership with North Tyneside CCG in developing the Integrated Care System in the borough, what risk assessments have been carried out specifically by North Tyneside officers with regards to the Integrated Care System and the possibility of this developing into a private health system which is underpinned by private health insurance?”
Given growing concerns about Council decision-making, KONPNE anticipated a certain amount of gloss, but the reply from Cllr Margaret Hall, on behalf of North Tyneside Council, was astonishing. In a prepared response, Cllr Hall stated publicly that “there is no need to oppose or object to the ICS, as there are no proposed changes to services”(not yet, Margaret, but there is an urgent need for you to do more reading around the subject to see where the ICS is heading…and, whilst you’re at it, also check out your own Labour Party’s policy:“We will stop Tory plans to further entrench the private sector delivery of health care under the cover of integration plans set out in the NHS Long Term Plan”(3)
Additionally, seemingly unfazed by her stance and in response to our second question, Cllr Hall went on to surprise the Chamber by stating “There is no way that North Tyneside Council would agree to privatisation in North Tyneside”(err, Margaret, just down the road at North Tyneside General Hospital, all of your “Urgent Care” and “Out of Hours” services are now privatised, and GPs throughout the Borough are scratching their heads and needing to discuss with patients private options following cuts to specific treatments that were up until recently available on the NHS).
We are unsure if this response by North Tyneside Council represents a head in the clouds (“don’t understand”) stance, or if it signifies a head in the sand (“don’t want to understand”) stance but, whichever, there is an acute need for the head to re-engage with reality. Whilst, no doubt, some North Tyneside Councillors are still willing to stand up and be counted regarding our NHS, we suggest that others need to see the bigger picture and not be taken in by the lengthy documents, smoke, mirrors and gloss offered by senior CCG officers. There is no excuse for this seemingly lack of insight by Councillors – much has been discussed locally and nationally, both within and outwith political parties and, together with many academics, Professor Allyson Pollock (Newcastle University) has researched and reported widely on the methodology strategically employed by the Government regarding NHS privatisation. (4)
The building blocks are in place and now that we have a Tory government for at least 5 years, so they have the political means to complete the privatisation of the NHS. Unlike those working in the CCG who are paid to carry out policy as dictated by the Government, our elected representatives on local Councils are the only piece of democratic accountability in the CCGs “Integrated Care System”. As such, it is CRUCIAL that Councillors hold firm in fighting against the covert introduction of cuts and privatisation, and do not passively collude with the political decision to dismantle our NHS. The people of the North East are placing our trust in our elected Councillors to continue to stand up for a fully funded, publicly owned and publicly provided National Health Service, which is available to all on the basis of need and NOT the ability to pay.
Dr Groom said after the meeting:“It remains our great concern that North Tyneside Council appear to have done a U turn and ridden roughshod over a Council motion unanimously passed two years previously, and have become complicit in the CCGs plans. Members of KONPNE were astonished by the response from Cllr Hall on behalf of North Tyneside Council; we will, of course, be taking this further, as we still require full and respectful responses to our concerns”.
Jude Letham, Co-ordinator, “Keep Our NHS Public North East” said:“Our group has been in existence for over ten years, and is made up of members of the public, including doctors and nurses – many live and work in North Tyneside. We believe in a publicly provided health service, and also believe it to be the responsibility of EVERYONE to stand up for these ideals, using whatever ways and means we can. All Councillors bear this responsibility”.
2 thoughts on “Welcome to North Tyneside Council….the lights are on, but is there anyone at home?”
What do you mean by privatisation? Does it refer to private companies contracting with the NHS to run services which remain free at the point of delivery? Or are you referring to a process whereby the NHS would be turned into an insurance based system? Because the two things are very different. If it is the latter what evidence do you have that the current plans for ICOs involve the replacement of a system funded through general taxation with an insurance based one? If it is the former what is your attitude to the fact that private business has been integrally involved in NHS provision since the services inception through the provision of general medical, not to mention pharmaceutical, dental and optical services, using private contractors?
Thank you for your comments. KONPNE feel that there are many difficulties regarding “Integrated Care Systems” as required by NHS England and put into practice by local CCGs. In short, these systems fail to really address the problems of NHS (dis)integration caused by the Health and Social Care Act and the market; they fail to address why true integration is not and can’t happen (e.g. lack of funding, the staffing crisis, privatisation of social care, charges for social care, and much more); they allow private corporations in the back door even more, providing commissioning support etc; they will be cash limited and lead to greater postcode lotteries; they further reduce local democratic say and accountability in health care planning and decisions.
As far as past private business (eg: general medical) involvement in the NHS is concerned, we feel that there is a world of difference between, for example, a local group of GPs with personal knowledge of patients and the patch, and the huge international corporations which have already been awarded lucrative health care contracts throughout England.
It is unsurprising to note that the recent imposition of ICSs takes privatisation one step further by laying the groundwork for “Integrated Care Providers”. ICPs involve one lead provider (NHS or private), who can then subcontract to other providers, be they NHS or private. The obvious issue is that this opens the field (perhaps not immediately…but in time…) to large-scale multinational corporation involvement in healthcare provision. This is the model found in the States, often underwritten by private health insurance ….and Is the NHS “off the table” as far as trade deals are concerned? We feel it would be naive to think so – this is part and parcel of long term plans for NHS privatisation.
“How to dismantle the NHS in 10 Easy Steps” (El-Gingihy, 2015) outlines the organisational changes to our healthcare provision of the last two decades and, to fully understand our concerns relating to NHS privatisation, we feel it crucial to stand back to see the bigger picture – the strategic processes which have been instrumental to the growth in NHS privatisation.
Given this process, it is of the utmost importance that Dr Groom, on behalf of KONPNE, highlights these issues and asks North Tyneside Councillors for information relating to their assessment of risk regarding the possibility of the ICS developing into a private health system.
I hope that this very brief resume offers some clarity about this situation and our stance – there is also much written about these crucially important issues. We are grateful for your comments and please do not hesitate to make contact at konpnortheast@gmail.com if any more information is required.
konpnortheast.com 
What do you mean by privatisation? Does it refer to private companies contracting with the NHS to run services which remain free at the point of delivery? Or are you referring to a process whereby the NHS would be turned into an insurance based system? Because the two things are very different. If it is the latter what evidence do you have that the current plans for ICOs involve the replacement of a system funded through general taxation with an insurance based one? If it is the former what is your attitude to the fact that private business has been integrally involved in NHS provision since the services inception through the provision of general medical, not to mention pharmaceutical, dental and optical services, using private contractors?
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Thank you for your comments. KONPNE feel that there are many difficulties regarding “Integrated Care Systems” as required by NHS England and put into practice by local CCGs. In short, these systems fail to really address the problems of NHS (dis)integration caused by the Health and Social Care Act and the market; they fail to address why true integration is not and can’t happen (e.g. lack of funding, the staffing crisis, privatisation of social care, charges for social care, and much more); they allow private corporations in the back door even more, providing commissioning support etc; they will be cash limited and lead to greater postcode lotteries; they further reduce local democratic say and accountability in health care planning and decisions.
As far as past private business (eg: general medical) involvement in the NHS is concerned, we feel that there is a world of difference between, for example, a local group of GPs with personal knowledge of patients and the patch, and the huge international corporations which have already been awarded lucrative health care contracts throughout England.
It is unsurprising to note that the recent imposition of ICSs takes privatisation one step further by laying the groundwork for “Integrated Care Providers”. ICPs involve one lead provider (NHS or private), who can then subcontract to other providers, be they NHS or private. The obvious issue is that this opens the field (perhaps not immediately…but in time…) to large-scale multinational corporation involvement in healthcare provision. This is the model found in the States, often underwritten by private health insurance ….and Is the NHS “off the table” as far as trade deals are concerned? We feel it would be naive to think so – this is part and parcel of long term plans for NHS privatisation.
“How to dismantle the NHS in 10 Easy Steps” (El-Gingihy, 2015) outlines the organisational changes to our healthcare provision of the last two decades and, to fully understand our concerns relating to NHS privatisation, we feel it crucial to stand back to see the bigger picture – the strategic processes which have been instrumental to the growth in NHS privatisation.
Given this process, it is of the utmost importance that Dr Groom, on behalf of KONPNE, highlights these issues and asks North Tyneside Councillors for information relating to their assessment of risk regarding the possibility of the ICS developing into a private health system.
I hope that this very brief resume offers some clarity about this situation and our stance – there is also much written about these crucially important issues. We are grateful for your comments and please do not hesitate to make contact at konpnortheast@gmail.com if any more information is required.
John Whalley
Steering Group member, KONPNE
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