We are now being given the run around on hospital plans ....

Last Wednesday 8th June Mike Williams - boss of the PCT - came to the Town Hall and explained to the members of HUG (The Healthcare Users Group) and about sixty members of the public how things presently stand.  The PCT have been listening carefully to our comments and several weeks ago wrote outlining their latest proposals. Most importantly they said that they believed it was now possible to have the 14 intermediate care Hospital beds managed and staffed by the NHS in their own separate wing in the new Hospital/Care Home complex..  Previous proposals had been for the hospital beds to be run by the Order of St John along with the new Care Home beds. We were absolutely delighted by this news. It really looked as if things were now getting settled in a way we could get behind. One result was that the Hospital never became a divisive issue at the Election. The moment the election was over, the Oxford County Council suddenly started finding all kinds of problems with the  plan. It was going to cost more and that wasn't possible. This was the news Mike Williams bought to us on Wednesday. He had not found a solution and it didn't look good.  It began to look as if the Hospital beds were moving back into the maws of the OSJ. The audience in the Town Hall made their feelings about this abundantly clear. There was to be another "urgent" meeting between the PCT and the OCC on the 23rd June to try and find a settlement. Residents of Chipping Norton - we are being given the run around. This is no time to be backing down on the demands we have been making for well over a year now.

The next day the indefatigable Clive Hill (LEFT) - who has masterminded the whole protest campaign and was the most expert and voluble HUG spokesman in the Town Hall meeting - appeared in front of the Oxfordshire Health Overview and Scrutiny Committee - on which our new county councillor Hilary Biles (RIGHT) serves. This powerful committee has to be consulted on any major changes to health provision in the area. If its not happy it has the power to refer decisions to the Minister. It is made up of representatives from the Districts, Oxford City as well as the county. Its political make-up reflects the composition of local councils. It hasn't been going long and is still feeling its way - but it does in effect represent the only serious watchdog for us healthcare consumers. The committee should not be an easy pushover for the County Council - even though the new Tory Power structure is clearly in play!! Clive recommended to the committee that they should accept the plans put forward by the PCT in Mike Williams recent letter. He made the following points....

• When I spoke to you at your March meeting I indicated that we felt little progress was being made

Hilary Biles had strongly urged Clive Hill to attend the committee meeting and was very pleased with the input which Clive Hill made. Hilary writes ;"It is  important for members to get the feel of how people on the ground really feel. Clive acknowledged and applauded the way the PCT had responded to the consultation over the past few months with proposals which the people of Chipping Norton were happy to support. The committee were clearly impressed with Clive's positive and fair minded approach. The Committee listened carefully. In the discussion I was adamant that should there be any change to the proposals then the PCT needed to come back to the committee under section 7 and 11 of the Health Act. That is what was decided. We had unanimous support!!!!

To me, it was imperative the proposal from the PCT was accepted albeit with the line ‘subject to finance ‘. The alternative was to turn the consultation down - since we had been advised by the Independent Reconfiguration Panel that it was necessary to respond to the PCT by the 9^th June. We have all worked too long and hard for this to fall and it is far better to move forward with the commitments we have from the PCT.  There is no doubt this will be a problem for the Oxfordshire Care Partnership and there will need to be future meeting on viability, although I am myself convinced it will be viable or that we would be able to make it viable "

The ball is now in the County Council's court and we await the 23rd June with some anxiety.

READ SOME OF THE BACKGROUND TO WHERE WE ARE NOW.

It is just not reasonable that we should have to spend another summer debating the hospital issue. This thing has to be settled. On Saturday morning the League of Friends organised a chance to meet representatives from the County Council, the PCT and the local action groups so that members of the public could judge for themselves exactly how things stand. Outstanding questions like the MIU will hopefully soon be settled with the PCT. Transport arrangements with the OCC. But there is one remaining, financially sensitive big issue where both parties are involved and the argument is about whose budget pays for what. This is the question of whether the 14 intermediate care beds will be staffed and run by the NHS or the Order of St John. What was obvious to anyone spending more than a couple of minutes talking with either the OCC or the PCT on Saturday was that these two august organisations are arguing pretty fiercely about this...and some of us (by now) experienced observers are really beginning to wonder whether failure to agree about it could be a deal breaker.

Let me try and explain the issue - although god knows why you should have to spend your time trying to understand the ins and outs of Public Sector accounting any more than I should. This whole thing goes back to the fact that the County Council has to replace a lot of its Care Homes because they are simply not up to scratch. The OCC has no money for this so it did a deal with two Private Sector organisations - Order of St John (who run and mange Care Homes) and the Pilgrim Housing Trust (who build them). Together they formed a joint venture called the Oxford Care Partnership. This OCP has a huge 25 year contract with OCC to run all its Care Homes, refurbish the existing stock and build new homes where required. Finance is raised privately. OCP get their income from OCC contracting to buy "socially funded" beds in the homes at an agreed bed rate and by the Order of St John marketing some of the beds in the homes on a private fee-paying basis. The OCP has always insisted that the economics of all this (including its bed rate) depends on building a viable size home which two years ago they said was 70 beds. There was never any chance of a Care Home that size being required in Chippy so this is why the first deal came to be done.  First the OCP had its arm twisted and decided that 50 beds was viable. 20 beds were required by OCC. OSJ would market 18 privately. That left 12 needed.....and that was the moment somebody looked around and realised that if the intermediate care beds in the hospital could be brought into the equation and transferred to the Order of St John  then the financial calculations worked. And so the "joined-up" proposal was born. Out of sheer financial necessity and don't let anyone tell you otherwise!! Move forward a year - to this very week. The Chippy Action Groups after a years fight have now persuaded the PCT  that the intermediate care beds must actually stay within the NHS. The PCT have told us in writing that they think this is possible and will do their utmost to make it happen. The PCT have now told this to the OCC who have told the Order of St John - and World War 3 seems to have broken out. The Order of St John claim that this blows the economics and their bed rate to bits...they will now be operating a 36 bed unit. Put simply .....they want a lot more money per bed.  And they know exactly where that extra could come from - eyeing the real estate value of the existing hospital, with some creative ideas about how capital can be converted into revenue. There are some really confusing technicalities which now get introduced into the discussion - like registration requirements, VAT regulations, caps on re-investment. The PCT have some other ideas of their own. There are any number of "bookkeeping" options. We seem to be in a good old fashioned Fish Market. Us laymen are "lost" - which is presumably exactly what is intended. This is  what happens when you bring private finance into the provision of vital public services. Some people will say its a healthy development.  For my part - I think - just like a Fish Market - it stinks. As the public we have a right to far more transparency than we have had in all of this so far. Contract figures and fees are claimed as commercially sensitive and confidential. That's not good enough when the continued existence of our local services depends on these figures. What kind of democracy is this? We need access to the arithmetic!!

On June 8th the OCC and the Order of St John meet the PCT and that does look like High Noon. If they can't agree some figures between them then we are back to square one - because the Action Group is simply not minded to give up on its demand that the hospital beds should stay within the NHS. On June 9th the Health Overview and Scrutiny Committee meet in Oxford and there may be a first public indication of how things are moving.  We rely on our new County Councillor to fight Chippy's corner at that meeting. Meanwhile though - some people left last Saturday morning's  meeting a lot less cheerful than when they went in.

HOSPITAL UPDATE
from Revd. Steve Weston (left) Chair, Healthcare Users’ Group and Chunky Townley (right) Chair, Hospital Action Group
 

Meanwhile, perhaps we better get our hospital settled fast. The Oxford Mail reports today......"Health managers are gearing up for the second major NHS shake-up in Oxfordshire in three years. Proposals have been drawn up to reorganise the county's five primary care trusts, which oversee community services like GPs and dentists (and community hospitals) . The move could see the number reduced to three, covering Oxford, and north and south regions, or even amalgamated into one Oxfordshire body. Staff said the five organisations already worked together on projects and services, and a reduction would help save money. But while top-tier management would be lost, it is unlikely the move will lead to job cuts among health workers. At present, the five PCTs do not correspond to the boundaries of the county's five district councils. The changes would align community healthcare with local government, making it easier for councillors to help with future NHS initiatives. Oxford City PCT yesterday agreed to the proposals, and showed preference for one countywide organisation. The other four groups will make their decision next week".

After seven weeks 4214 people from the town and around have signed this petition. Have you signed yet?
 

Chippy HOSPITAL DEBATE....
after the Church Meeting more politics!

The PCT snubbed last week's mass meeting in the Church (see report below). They obviously prefer to play the political game in committee rooms rather than meeting 500 worried people. This week there are two important committee meetings  - both of which the PCT are attending in force! The first was on Monday in Banbury - a Special meeting of the Northern sub-committee of the County Health Overview and Scrutiny Committee. Then on Thursday the full Scrutiny Committee meets in Oxford. The Monday meeting was a farce. Take a bow Elizabeth MacLeod - Cherwell District Councillor for Banbury Calthorpe  (left) who was in the chair and repeatedly "steered" the meeting - expressing her own views before any members had spoken -  cardinal sin for committee chairmen.  She certainly influenced a vote for a resolution by giving a report of her understanding of what the Chairman of the parent committee thought about things. Absolutely out of order. And when the vote was won - the Chief Executive of the PCT turned to her and said  "Well done  Thankyou Elizabeth". It seemed pretty clear who was on whose side.  But to start at the beginning. The special meeting was specifically called for the PCT to present a business case justifying its present proposals for Chipping Norton Hospital. All of us who had been present at the previous meeting were quite clear that this was the one and only purpose of the special meeting. The Chairman of this committee had even told the meeting in Chippy Church a few days earlier that she had asked for a business case and was expecting one on Monday. The PCT simply never bothered to produce a business case for this meeting. The meeting should have been terminated at that point. What they produced instead was 127 pages of old previous reports stapled together. What the PCT Chief Executive called a "paper trail" ( an expression normally used for describing  evidence in fraud cases!)  We have seen all these reports before. We have been told that some of the figures in these reports are wrong. None the less - the Committee Chairman thanked the Chief Executive and said this was exactly what the committee had asked for. This was untrue - the committee had asked for much more than a "cut and paste" job. There were gasps from the public gallery.  How is it possible for agencies who are being "scrutinised" by a Public committee to simply ignore requests for information - and get away with it?  What the Chief Executive had also brought along  was a "compromise" proposal - in the hope of getting some closure on this Chipping Norton Hospital issue which had now dragged on for too long and was getting stuck on what he described as "arcane" details.  This guy Nigel Webb certainly has plenty of chutzpah. He said it was clear that the people of Chipping Norton were either incapable or unwilling to understand the proposals being made (Well thanks Nigel). He re-iterated his condemnation of Chippy Hospital - saying this time that it should have been closed down fifty years ago. The "arcane" detail pre-occupying people in Chippy is to ensure that nursing in the new hospital continues under the management of the NHS - and is not handed over to the Orders of St John. We are absolutely convinced that it is possible to do this at no extra cost and we simply don't understand why the PCT are being so obdurate. We are convinced that there must be a hidden agenda which seems to involve the  interests of the Order of St John. However - nobody will provide the facts so how can we be sure? But the Chief Executive had a new wheeze. He now proposed that nursing staff in Chippy hospital would be guaranteed all NHS terms and conditions for three years after the commissioning of the new hospital - that's roughly five years in total from now. This guarantee would apply to existing staff and any new staff recruited in the period. It would not apply to non-nursing staff like care assistants, cleaners etc. Management of the nursing staff would remain with the Orders of St John. The Chairman wanted to take a unanimous recommendation to the Parent Committee on Thursday and it soon became clear that she wanted this to be an acceptance of the new proposal. She even had a resolution already drafted and prepared. She also indicated that the Chairman of the Parent Committee had told her that this new proposal was satisfactory to him. She also told us that Cherwell District Council supported the proposal.  A great deal of preparatory lobbying had gone on. Were any of these pre-meeting shenanigans proper? A councillor from Northamptonshire took it upon himself to address the people of Chipping Norton. He said (quite rightly) that they seem to want to keep what they have at the moment but in a new building. They have been told they can't have that. They must simply accept it and trust the PCT. (Where on earth do they find these people?) He probably knows as much about  Chipping Norton as we know about South Northamptonshire. The two councillors from West Oxfordshire then got stuck in. Mike Howes (Conservative District Councillor for Chipping Norton) attacked the complexity, costs and confusing nature of the proposals. Stuart Brooks - Liberal Democrat District Councillor for Freeland and Hanborough (right) - did a forensic job on the figures contained in the PCT paper on the different Options and demonstrated to the complete satisfaction of most people present that it would be possible to have the Intermediate Care Beds managed by the NHS at the same kind of cost as the option (Option 2) which had actually been selected. The PCT never answered Councillor Brooks' points and the Chairman did not press them to do so. They said rather loftily that the choice of option had not been entirely on the basis of the financial figures.  So what was the basis then? was the question crying out to be asked. Nobody asked it. The Chairman reported on her visit to the Chippy Church meeting and said the majority of people would be happy to accept a healthcare facility in place of a hospital. This completely puzzled the Chippy representatives present since they know that such a statement  is totally untrue. Where on earth did the Chairman get this idea? The Chairman hurried on to say that one crucial thing about which the Parent Committee would want reassurance was whether the Hospital Staff had been consulted. The three senior PCT managers Nigel Webb, Jonathan Coombs and Hazel Knott sat there looking totally sincere, nodding their heads in a concerned way and assured the Chairman that they had all spoken recently to the staff, they could only formally consult when there was a firm proposal , the staff were proud to be members of the NHS and yes they had some anxieties about the uncertainty - but then that was true of all NHS staff at the moment. "Well that's fine" said the Chairman. Everyone from Chipping Norton knows that there is furious unhappiness among the hospital staff and the chances of any of them being willing to transfer to work for the Orders of St John is pretty slim. Somebody needs to make sure the Parent Committee knows this because it doesn't look as if the Chairman will pass the word on. The Chairman finally put her resolution to a vote - to accept the PCT's compromise proposal.  Only two voted against - Councillors Howes and Brooks  - both from West Oxfordshire. The other six all voted for - none of them had asked a substantial question of the PCT during the meeting. They come from Brackley, South Northamptonshire and Banbury. (Last year the arrangement was that the Northamptonshire contingent did not vote on issues which did not affect them. When and why did this change?) The committee's recommendation now goes to the full meeting in Oxford on Thursday. One person who was going apoplectic during all of this was Hilary Biles (left) - County Councillor for Chipping Norton. Hilary had addressed the meeting at the outset and had then been "muzzled" by the Chairman and dismissed to the public benches. Hilary was Chairman of this committee last year. She was proud of the committee and worked hard to maintain its independence. Today she was in despair. She and Clive Hill will both have five minutes each at the full meeting to report on the travesty that was the Northern Committee. The full committee must realise that they are now the only watchdog for electors in Local Health Matters. We expect them to be challenging and demanding in scrutinising the plans of local trusts and PCTs. They haven't been in operation very long. They must not get a reputation for being a pushover.  A couple of months ago on 9th June they laid out the terms under which they approved the Chipping Norton Consultation process - and made it clear they expected management of the hospital beds would remain with the NHS. If they didn't they would require a new consultation. Well that's where we are now.  Come and find out what happens next. County Hall. Thursday. 11.45am. It could be High Noon for the new Chippy Hospital. Will it all end with a bang or a whimper?