Questions to NE Councils re Integrated Care Systems

Summer 2022 to Spring 2023:

KONPNE are putting formal questions to full Council meetings in the North East

Date 10/04/2018 COUNCIL FORCED TO DENY CLAIMS THEIR STREET LIGHTS CAUSE CANCER, MISCARRIAGES AND NOSE BLEEDS Gateshead Council has been forced to deny claims that their STREET LIGHTS cause cancer, miscarriages and nose bleeds. Gateshead Council has released an official statement after “conspiracy theories” began circulating on social media about the lights being fitted with 5G technology and killing birds and insects. The statement reads: “We are aware that certain individuals are frightening local people with false stories about the street lights in Gateshead – despite the fact we, and others, have told them repeatedly that their allegations are entirely false. “For your reassurance, we’d like to set the record straight. “Gateshead Council DOES NOT use 5G technology in any of its street lights, or in any other capacity. It has never done so.”The street lights in Gateshead will not give you cancer. See copy By North News

A road sign welcoming people to England and Northumberland. Northumberland is a county in North East England. The northernmost county of England, it borders Cumbria to the west, County Durham and Tyne and Wear to the south and the Scottish Borders to the north.

North East and North Cumbria Integrated Care System (NENC ICS) is responsible for commissioning all health care in the region, from 1st July 2022. We have massive concerns about this new system – see our webpage here.

NHS campaigners in the North East are putting formal questions to seven North East councils to determine their stance on this development – given that the ICSs are under instruction from NHS England, our local Councillors are our representatives regarding this new programme, and we need to ensure that they are accountable in standing up for our NHS.

Scroll down for our contacts with Durham, Sunderland, Newcastle, Northumberland, Gateshead and South Tyneside Councils, and a DISGRACEFUL response from North Tyneside Council.

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22nd June 2022 – Durham County Council

KONPNE campaigner Dr Lawrence Welch presented the following to Durham County Council – click here for the Council papers and the link to watch the stream via youtube.

“I speak on behalf of “Keep Our NHS Public North East”.

Further to the Health and Care Act 2022, “North East and North CumbriaIntegrated Care System” will be responsible for commissioning all healthcare for County Durham from the beginning of July this year, and I am aware that plans from NHS England outline a much-reduced Councillor and public involvement in decision-making regarding our future health services.

Please outline what Durham County Council is doing to promote local participation and scrutiny regarding decision-making, and please confirm that Durham County Council upholds the principle that the NHS must be comprehensive, universal and free at the point of use and based on the clinical needs of patients – not on the new Integrated Care Boards financial considerations”.

The audio quality on the IT livestream was very poor (on our laptop, at least), so we wait until receipt of the Council minutes to see the exact response…but we were able to make out that the Council claims that they are working towards enabling as much commissioning and resources as possible at the County Durham level, were engaged with the Integrated Care System at a County level, and were also involved in an Integrated Care Plan with South Tyneside, Sunderland and the ICS. The person speaking on behalf of Durham County Council concluded that they are “engaged positively with the ICS”.

We will see.

Great work by KONPNE campaigner and Durham resident Dr Lawrence Welch. 

NOW AVAILABLE:

CLICK HERE

for the response from Cllr P Sexton, Cabinet Portfolio Holder for Adult and Health Services, Durham County Council 

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22nd June 2022 – Sunderland City Council

Laura Murrell, Secretary of Sunderland and District KONP submitted the following question to Sunderland City Council – click here for the Council papers and here for the link to to the live stream

“The North East and North Cumbria Integrated Care System” (NENC ICS) will be responsible for commissioning all healthcare for Sunderland from the 1st July 2022.

I believe it will result in a much-reduced involvement by councillors and the public in decision-making regarding our future health services. However, private companies can be members of the ICS Board and its other bodies, so they will be able to participate in decisions about how the ICS budget is spent and what services will be delivered to whom and by whom, increasing their influence and making it more likely that they will provide NHS services.

Please could you explain what Sunderland City Council is doing to promote local participation and scrutiny regarding decision-making by the ICS; to ensure that the ICS does not permit private sector representatives to participate in decision making on its board, committees or other bodies with delegated powers; and what it can do to encourage the ICS to end the outsourcing and privatisation of NHS services.”

A response was made by Councillor Kelly Chequer, on behalf of Sunderland City Council. Councillor Chequer confirmed that there will be no private sector representation on the Integrated Care System Board in this region and that there are, indeed, seats for four local government representatives. Involvement in local decision-making and health scrutiny are in place, as is involvement with the regional Integrated Care Partnership with Sunderland, South Tyneside and Durham. Councillor Chequer confirmed that she has written to Sam Allen (CEO of North East and North Cumbria ICS) to confirm the need for a genuine involvement in healthcare planning.

KONPNE: ….. so, there is much for Councillors (and Campaigners) to follow up on. There are, of course, huge outstanding issues and concerns regarding the new “North East and North Cumbria Integrated Care System” – see here– and it is crucial that Sunderland and all North East Councils engage with the ICS and fight to retain the NHS.

Many thanks to NHS campaigner Laura Murrell, Secretary of Sunderland and District KONP.

CLICK HERE

to read the response from Kelly Chequer, Portfolio Holder for Healthy City

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6th July 2022 – Newcastle City Council

NHS campaigner and Newcastle resident Clare Bethell continued KONPNE’s planned sequence of putting formal questions to seven Councils in the North East. The aim is to determine each Councils stance on the new North East and North Cumbria Integrated Care System (NENC ICS), which is responsible for commissioning all health care in the region, as from 1st July 2022. We have massive concerns about this new system – see our webpage here.

Clare put the following question to Newcastle City Council at tonights full council meeting:

“I speak on behalf of “Keep Our NHS Public North East”.

Further to the deeply flawed Health and Care Act 2022, “North East and North Cumbria Integrated Care System” is responsible for commissioning all healthcare for the City of Newcastle upon Tyne from 1st July this year. There are potentially a number of problematic areas associated with the new Integrated Care System, and some of these difficulties may be addressed and remedied locally through attention to the wording of the Constitution of the new ” North East and North Cumbria Integrated Care Board”. 

Issues that need to be clearly stated within the Constitution include 

– the ICS commitment to maintain a comprehensive health service, free at the point of need, and accessible to all residing in the area

– the need to exclude representatives from private sector organisations on any ICS board or committee

– a commitment that NHS providers are the default providers of health services

– vigorous scrutiny, transparency and accountability with all new contracts

– a commitment that anyone who needs emergency care while present in Newcastle will receive the necessary treatment, whether or not they are registered with a GP in the area

– a commitment that the Integrated Care Board will include a Councillor from each local authority and representatives from the range of health professionals and patient groups; this will uphold local democracy and transparency

– a commitment to hold all meetings of Boards and Committees in public, making papers available, and welcoming questions from the public

– the requirement for the full assessment of health and care needs, and availability of social supports, prior to a patients discharge from hospital

– the need for all NHS providers within the area to adhere to nationally agreed pay, terms and conditions, as negotiated with NHS staff Unions

I would be grateful if you would please outline what Newcastle City Council is doing to promote these issues when in contact with officers of the Integrated Care System, and please confirm that Newcastle City Council upholds the principle that the NHS must be comprehensive, universal and free at the point of use and based on the clinical needs of patients – not on the new Integrated Care Boards financial considerations.”

Councillor Karen Kilgour, Deputy Leader of the Council, replied on behalf of Newcastle City Council. Councillor Kilgour confirmed that the Council has a role to play regarding the ICS, but no power to set commitments on behalf of the ICS. She confirmed that Newcastle City Council does have some influence as to how the ICS evolves, and have suggested amendments to the Constitution of the new ICS. She confirmed opposition to any privatisation of the NHS and charging of any form, and confirmed that the move to the ICS won’t change peoples right to treatment in the city – people in the city who need emergency treatment will be able to access it, regardless of address. Councillor Kilgour stated how she has raised many issues and concerns regarding the ICS via the Local Government Association, and will continue to do so.

Clare Bethell, KONPNE campaigner, concluded her question with the following statement:

“We are aware that plans from NHS England outline a much-reduced Councillor and public involvement in decision-making regarding our future health services. This is a huge cause of concern as this does, of course, lead to a direct reduction in local democracy. This situation is both appalling and a disgrace. Please know that we, as Newcastle residents, want a publicly-funded and publicly-provided NHS, and that we support and expect our Councillors to stand up, to ask awkward questions, and to fight to protect our NHS. As from yesterday, we have all benefitted from 74 years of public healthcare – and we need our Councillors, now, to play your part in ensuring that the NHS remains for future generations. Thank you.”

Great work by KONPNE campaigner and Newcastle resident Clare Bethell.

The meeting was livestreamed, and this may be viewed on Youtube here  (go to minute 18.16 in the bottom right hand corner of the Youtube screen). To reiterate: “KONPNE supports and expects our Councillors to stand up, to ask awkward questions, and to fight to protect our NHS.”  

CLICK HERE

to read the question from KONPNE together with the response from Cllr Kilgour, Cabinet Member for a Healthy, Caring City (scroll to pages 3 and 4)

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12th July 2022 – North Tyneside Councillors in hiding??

North Tyneside Council, democracy and the NHS: The sign says WELCOME, but is there anyone at home?

Our next question was sent to North Tyneside Council by KONPNE Co-ordinator and North Tyneside resident Jude Letham.  We submitted a question on 12th July 2022 for the North Tyneside Council meeting scheduled for 21st July. We note the Council protocols around a commitment to transparency and accountability. Our question to the Council centred around their involvement with the new “North East and North Cumbria Integrated Care System”, which is now responsible for making decisions about treatments and commissioning health services in this geographical area – there are huge concerns about the ICS and the impact on local democracy and the further privatisation of the NHS. 

HOWEVER, KONPNE received an email response from the Council on 13th July 2022, stating that our question was not accepted for the Council meeting and will be referred to Council officers for a response.

“The Chair of Council considered your question for the Council meeting 21 July 2022 and decided that it be referred to officers to respond to you directly.  Your question will NOT be considered at the meeting next week”.

Strange…. but true.  Of course, we immediately emailed the Council on 14th July for information about the decision to reject our question for the full Council meeting….and now, MONTHS LATER, we have still not received their rationale. We feel that it is our democratic right to put questions to our elected representatives at a full Council meeting, and we await their reasoning around this. We will keep you updated. 

Click here to read our VERY REASONABLE and APPROPRIATE question to North Tyneside Council, and click here for information about ICSs.

22nd July 2022 – Three unsatisfactory responses from North Tyneside Council

NOT ONLY (1) have North Tyneside Council seen fit to disallow, without reason, our question (above) at the July 2022 Council Meeting AND (2) have totally ignored our subsequent request that this decision be reconsidered (click here – we are STILL AWAITING a reply) …. BUT ALSO (3) they have followed all this up with a totally inadequate and disturbing written response.

Whilst we expected a considered reply to our question about the Integrated Care System (ICS) from a Councillor, one of our elected representatives, instead we have received an anonymous “response” from the NT Council HQ at Silverlink. Forwarded to us by a Personal Assistant to the Director of Children’s and Adult Services, it would be good to know who actually wrote this response, as it does appear to reflect a copy and paste job from the ICS website, coupled with a reluctance to respond to (or attempt to side-step) our actual questions, and ending with what appears to be a very disturbing total disregard for the future of our NHS. 

There are only 4 Local Authority representatives on the Integrated Care Board (ICB), despite the ICS covering 14 Local Authorities across North Cumbria and the North East – and 3 of these reps are unelected Council Officers…..so much for democracy?  The response received from North Tyneside Council gives the impression that there is absolutely nothing amiss. We believe that representation at this level is important, as the ICB has ultimate authority regarding all future health contracts across the region, and sets the tone and direction of travel. It is also important to note that the ICB comprises people appointed by the Chair (who is, himself, appointed by NHS England) and, so, our one Councillor is the one and only elected representative of 3 million people across North Cumbria and the North East – we hope that s/he factors in some time for sleep at night. Obviously, tokenism springs to mind.  We believe that the ICB should include a Councillor from each Local Authority, not just one representative covering all 14 Local Authorities. 

And, of course, our fundamental concern is around the ongoing insidious privatisation of our NHS. It is totally unacceptable to read the dismissive statement in the final paragraph from North Tyneside Council that it will “continue to use its influence to ensure that contracts are awarded to providers who will deliver the best services to the residents of the borough”. There is NOTHING in the NT Council response to confirm the Councils commitment to a publicly-funded and publicly provided NHS. The North East and North Cumbria ICS Constitution should include a clear commitment that NHS providers be the default providers of health services, care and treatment and, as contracts with private sector companies come up for renewal, the default position is that they be awarded to NHS providers. We believe that our Councils and Councillors need to be clear in their support for this stance.

Our original questions remain unanswered by North Tyneside Council: 

What is North Tyneside Council doing to promote local participation and scrutiny of decision-making by the ICS and to ensure that the ICS does not permit private sector representatives to participate in decision making on its board, committees, or other bodies with delegated powers?

What will North Tyneside Council do to encourage the ICS to end the outsourcing and privatisation of NHS services?

Our original statement and question to North Tyneside Council is here and the North Tyneside Council response is here. We believe that the Councils response is shameful and we are, of course, following this up. We will keep you informed.

More information about “Integrated Care Systems”, private sector involvement, the composition of the Board, our Campaign so far, and about “North East and North Cumbria ICS” in particular is here. 

3rd August 2022 – Email to Chair of Health and Wellbeing Board, North Tyneside Council

Given the three shameful “responses” (if you can call them “responses”) from North Tyneside Council, KONPNE has today emailed Cllr Karen Clark, Chair of North Tyneside Health and Wellbeing Board, regarding our original question which, to date, has remained unanswered. We have also copied in all North Tyneside Councillors, and have provided details about our concerns. We will update all of our supporters when a reply is received. 

Our email to Cllr Clark is here, and the information sheet which spells out our concerns is here.

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21st September 2022 – Northumberland County Council

Unusually, Public Question Time for Northumberland County Council takes place immediately before the full Council meeting – it is not part of the formal full County Council meeting AND, unlike the full County Council meeting, there is no live stream…. It will be interesting to learn from the Council as to why they have decided to manage public questions in this way as it does appear to minimise the importance of public questions, reduces accessibility and accountability, and may serve to decrease local democracy. We feel that Northumberland County Council would do well to follow the example of the other six city / borough / county Councils in the North East by scheduling questions from the public as an integral part of the full Council meeting. 

Moving on to our question at this unusual “pre-meeting meeting” of Northumberland County Council…..Many thanks to KONPNE supporter Ed Bober from Morpeth, who put the following question to the Council:

“What is Northumberland County Council doing to promote local participation and scrutiny of decision-making by Integrated Care Systems and to ensure that the Integrated Care Systems do not permit private sector representatives to participate in decision making on its board, committees, or other bodies with delegated powers?”

The response from Councillor Wendy Pattison (Portfolio for Adults Wellbeing, NCC) appeared to show no cause for alarm, identifying a “regional partnership board” with Local Authority representation which will develop strategy for health and care services in Northumberland. Yes – we are aware of these so-called “partnership boards”, but this doesn’t get around the fact that the direction of travel for all health and care services in the North East is set by an overarching “Integrated Care Board”, with minimal (ie: one!!) Councillor representing the whole of the North East and North Cumbria… 3 million people….

As far as private sector representation on the main “Integrated Care Board” is concerned, Cllr Pattison admitted that Northumberland County Council “has no authority to ensure it operates in any particular manner”.  Well – we maintain that our elected Councillors should have a voice on this Board, and should be making their views known about this. Cllr Pattison went on to clarify that the Constitution of the Integrated Care Board identifies that no-one is permitted to be appointed to the Board, if the appointment could reasonably be regarded as undermining the NHS – and again, our point is that the word “reasonably” is open to a wide range of interpretation…. and the fact remains that, with this “let-out” clause in the Boards constitution, there exists a very clear route for private sector representation on the Integrated Care Board…. and our Councillors need to be vocal in working towards shutting the door on this.

Ed was given time to respond and ask a supplementary question, as follows:

“Is the County Council aware that the vast majority of public are against the privatisation of the health service?”

to which Cllr Pattison gave this totally unsatisfactory and “succinct” response:

“It is an interesting point, and we may take that on board”.

This “point” is more than interesting. We need our Councillors to be standing up and fighting for the future of our NHS and, in doing so, representing the views of Northumberland constituents. This “point” is central to all discussions and planning, and we demand that it is taken on board.

Given that the events of today took place at a pre-meeting meeting of Northumberland County Council (as opposed to the full Council meeting – for info, Northumberland County Council is an exception in that public questions, quite rightly, take place in the full Council meetings of the six other Councils in the NE), there is no official video record from Northumberland County Council…..and, unless we have missed it, there appears to be no link to public questions and responses on the Council website…..  the record of the proceedings is all….. very… vague.  We have asked for a written copy of Cllr Pattisons response, and also details as to where public questions and responses may be viewed.

KONPNE has some wonderful support from a group of NHS supporters in Morpeth and in other parts of he County. We are grateful to a colleague who took the following video:

CLICK HERE

to watch the video

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13th October 2022 – Gateshead Council

A question was to be put to Gateshead Council at their meeting planned for mid-September 2022, but the Full Council meeting was cancelled due to the period of mourning.

The rescheduled Full Council meeting took place on Thursday 13th October 2022, when KONPNE supporter and Peoples Assembly chair Tony Dowling asked the following question:

I speak on behalf of “Keep Our NHS Public North East”.

Further to the deeply flawed Health and Care Act 2022, you will be aware that “North East and North Cumbria Integrated Care System” is now responsible for commissioning all healthcare for Gateshead from 1st July this year.

There are potentially a number of problematic areas associated with the new Integrated Care System, and some of these difficulties may be addressed and remedied locally through attention to the wording of the Constitution of the new “North East and North Cumbria Integrated Care Board”. 

Issues that need to be clearly stated within the Constitution include:

– the ICS commitment to maintain a comprehensive health service, free at the point of need, and accessible to all residing in the area

– the need to exclude representatives from private sector organisations on any ICS board or committee; this issue is noted in the Constitution, but there is a “let-out” clause which allows private sector involvement

– a commitment that NHS providers are the default providers of health services

– vigorous scrutiny, transparency and accountability with all new contracts

– a commitment that anyone who needs emergency care while present in Gateshead will receive the necessary treatment, whether or not they are registered with a GP in the county

– a commitment that the Integrated Care Board will include a Councillor from each local authority; the current Constitution identifies one elected member to represent 14 local authorities covering a population of 3 million. Locally, three additional Council officers are identified for the Board, but these are not elected members.  There also need to be representatives from the range of health professionals and patient groups. This presence will uphold local democracy and transparency 

– a commitment to hold all meetings of Boards and Committees in public, making papers available, and welcoming questions from the public

– the requirement for the full assessment of health and care needs, and availability of social supports, prior to a patients discharge from hospital

– the need for all NHS providers within the area to adhere to nationally agreed pay, terms and conditions, as negotiated with NHS staff Unions

I would be grateful if you would please outline what Gateshead Council is doing with regard to each of these issues when in contact with officers of the Integrated Care System, and please confirm the Council’s stance is to support the principle that the NHS must be comprehensive, universal and free at the point of use and based on the clinical needs of patients – not on the new Integrated Care Boards’ financial considerations.

Councillor Lynne Caffrey responded to the question on behalf of Gateshead Council

CLICK HERE

to read the response from Gateshead Council.

The Council agenda and draft minutes are here: https://gateshead.moderngov.co.uk/ieListDocuments.aspx?CId=140&MId=3195

KONPNE: It is important to note the commitment of Gateshead Council to support a “free, universal, comprehensive NHS, based on clinical need” and the thorough response from Cllr Caffrey. KONPNE are aware that many Councillors in the North East are supportive and stand by the NHS.

We feel, however, that there are a number of issues associated with the response that are important to highlight.

The ICS, as it currently stands, serves to increase inequalities in service provision, as the 42 health systems across England are charged solely with providing core services – all else is locally determined and, thus, a postcode lottery is under development. History has shown that many references to “productivity and value for money” can be interpreted as cuts / downgrading / lower grades of staff / self help / or privatisation (Gateshead Council response, paragraph 6)

We maintain the stance that there should be representation from each of the 14 local Councils on the Integrated Care Board – this Board sets the direction of travel for the whole ICS, and Councillors are our sole democratically elected representatives. Whilst the number of LA  members of the Board has been increased from one to four, three of these are Council officers….there remains only the one Councillor who has been democratically elected…. and with a population of over 3 million to represent. There is also the inherent issue of the 14 Councils having different priorities / local needs / political allegiances, and how this may be effectively managed and represented with regard to the Board (Gateshead Council response, paragraphs 7 and 8).

It is clear that the ICS Constitution does, indeed, establish a nebulous “let-out clause” which allows private sector healthcare reps to sit on the Integrated Care Board – they are excluded from the Board only if they could reasonably be regarded as undermining the independence of the health service because of their private sector credentials…. and, as we all know, what is reasonable to one person may be very different to the next person (Gateshead Council response, paragraphs 9 and 10).

We feel that there is a world of difference between GPs working in localised Primary Care services to set NHS contracts, and multinational corporations with shareholders. The ICS, with a stand alone Board and budget, opens the door much wider to private sector takeovers; not on the scale of one service or department but, potentially, on a macro privatisation scale of a whole ICS region (Gateshead Council response, final paragraph)

As we have done with all Councillors in the NE, KONPNE will be forwarding information to all Councillors sitting on Gateshead Council about the above issues.

Many thanks to Tony Dowling, Gateshead resident and Chair of North East Peoples Assembly, for putting this question to the Council. 

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South Tyneside Council

In February 2023, Maddy Nettleship kindly submitted the following question to South Tyneside Council, on behalf of KONPNE:

As I am sure the council is aware , the Health & Care Act 2022 has introduced changes in July 2022 whereby the North East and North Cumbria Integrated Care system is now responsible for commissioning all healthcare for the people of South Tyneside.
This takes the decision making about OUR healthcare further away from our council representatives and and even further from public involvement in deciding the future of OUR health service.
We would like to know how South Tyneside council intends to promote both scrutiny and local participation in the decision making about OUR NHS. and how they would try to prevent representatives of the private sector participating in such decisions by the ICS on the present and future of health care in South Tyneside and elsewhere in the North East. 
I would also like to know within the above context what South Tyneside council intend to do about ending outsourcing and privatisation within the NHS and ensure the health needs of the people of South Tyneside are placed before financial considerations in decisions about our health care.

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Our PREVIOUS round of questions to NE Councils

Throughout autumn and winter 2020/21 and prompted by the recent growth in “outsourcing” / aka NHS privatisation,  members of KONPNE put formal questions to all SEVEN local North East Councils about privatisation in their area. Click here to see how they shaped up….

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