Agenda item

Motion - Oppose Integrated Care Systems in the English NHS

Minutes:

Councillor Brian Kenny moved and Councillor Kate Cannon seconded a motion submitted in accordance with Standing Order 13.

 

In moving the motion, Councillor Kenny confirmed that he was happy to accept the Liberal Democrat Group amendment, which was moved by Councillor Phil Gilchrist, and seconded by Councillor Dave Mitchell as follows:

 

‘Insert after point 7 (under 'Council notes -')...

 

8.  the Health and Care Bill received its second reading in the House of Commons with a substantial Conservative Majority on 14July 2021 despite widespread concern over its contents.

9.  the contents of the proposals have been under critical examination at sittings of the Commons Health and Care Committee in order to understand its full impact, with sittings planned through to 2November 2021.

 

Insert after point 5 (under 'Council believes -')...

 

6.  That in August and September Councils, the Clinical Commissioning Groups and many bodies were sent guidance on ‘the development of place based partnerships as part of statutory integrated care systems’.

 

The latter specifically states that, ‘where decision making affects communities, groups or specific services, these arrangements…should fully engage those affected, including populations, people who use services and carers across health and social care’

 

This Council pledges to make sure that will be the case.

 

Insert after 'mean...' on the penultimate line in point (1) (under Council therefore resolves to)...

 

(2)  request that  the guidance ‘‘working together at scale’ issued in August which states that NHS Trusts, when seeking  to ‘reduce unwarranted variation' and ‘inequality in health outcomes’  is accompanied by clarity over the movement of resources;

(3)  request that Wirral is given a clear explanation of the implications of the plans to ‘ensure that specialisation and consolidation occur where this will provide better outcomes and value’ 

(4) request a financial forecast of the full context that Wirral will face as Edward Argar MP has stated ‘local systems will be informed of their resource envelope at the start of the year and will be required to agree a plan that matches, or is within, that envelope’

 

Following a debate, and Councillor Kenny having replied, six Members rose to request a recorded vote.

 

A recorded vote was then taken and the Council divided as follows:

 

For the motion (41) - Councillors J Bird, A Brame, D Brennan, K Cannon, C Carubia, P Cleary, H Collinson, C Cooke, T Cottier, G Davies, S Foulkes, S Frost, P Gilchrist, E Gleaves, H Gorman, K Greaney, E Grey, S Hayes, AER Jones, C Jones, T Jones, S Kelly, B Kenny, D Kenny, P Martin, M McLaughlin, J McManus, D Mitchell, Y Nolan, C O’Hagan, J Robinson, T Smith, C Spriggs, P Stuart, Jason Walsh, Joe Walsh, S Whittingham, I Williams, J Williams, J Williamson and G Wood. 

 

Against the motion (23) – Councillors T Anderson, B Berry, M Booth, D Burgess-Joyce, H Cameron, I Camphor, W Clements, M Collins, T Cox, A Gardner, J Green, P Hayes, A Hodson, K Hodson, J Johnson, M Jordan, I Lewis, S Mountney, C Povall, L Rennie, L Rowlands, S Williams and A Wright. 

 

The substantive motion, as amended, was therefore –

 

Resolved (41:23) –

 

Council notes –

 

1.  The NHS in England is rapidly being reorganised into 42 regional Integrated Care Systems (ICSs), while the Covid pandemic still rages. These ICSs may strengthen the role of private companies, including US health insurance corporations, in the health and care system.

 

2.  Government is in the process of passing new legislation to make ICSs into statutory bodies.

 

3.  ICSs are supposed to operate as partnerships between the NHS, local authorities and others, but the plans, which make ICS systems accountable nationally to the Secretary of State, may actually sideline local authorities, threatening the future integrity of social care and reducing local accountability. Meaning that health and care services in Wirral are controlled by Cheshire and Merseyside ICS

 

4.  Despite claiming to ‘integrate’ health and social care services for the benefit of patients, ICSs are actually adapted from a model from the United States, which aims to reduce spending on health and care through increasing costs to people using the services

 

5.  ICSs will operate with fixed annual budgets for a wide range of health and social care services, which could lead to a diminishing focus on place-based priorities for Wirral.

 

6.  Some 83 corporations and businesses, including 22 from the US, are already getting heavily involved in developing ICSs and could even sit on their boards, thus putting profit making companies in a position to influence decisions on health and care at a Wirral and regional level.

 

7.  ICSs will be accountable to the Secretary of State, and ICS plans will be binding. They could mean more private contracts, more down-skilling and outsourcing of NHS jobs, reduced services (partially replaced by ‘digital’ options and volunteers) and significant spending cuts.

 

8.  The Health and Care Bill received its second reading in the House of Commons with a substantial Conservative Majority on 14July 2021 despite widespread concern over its contents.

 

9.  The contents of the proposals have been under critical examination at sittings of the Commons Health and Care Committee in order to understand its full impact, with sittings planned through to 2November 2021.

 

Council believes –

 

1.  There has been little opportunity for adequate consultation or explanation of this legislation and its consequences for Wirral residents.

 

2.  The introduction of Integrated Care Systems could threaten patient care, jobs, working conditions and the integrity of the NHS as a public service.

 

3.  After 30 years of marketisation, it is time to restore the NHS to a fully accountable public service, which is provided free to all at the point of use.

 

4.  Government should commit to a separate, collaborative, publicly funded Social Care Service.

 

5.  Genuinely integrated services should take into account the wider determinants of health, such as housing, employment and environment. This would involve more input from local authorities.

 

6.  That in August and September Councils, the Clinical Commissioning Groups and many bodies were sent guidance on ‘the development of place based partnerships as part of statutory integrated care systems’. The latter specifically states that, ‘where decision making affects communities, groups or specific services, these arrangements…should fully engage those affected, including populations, people who use services and carers across health and social care’

 

This Council pledges to make sure that will be the case.

 

Council therefore resolves to –

 

(1)  request the Leader and Chief Executive write to the Secretary of State for Health & Social Care and ask for an extended and meaningful consultation with the public, so that the residents of Wirral are fully aware of what the changes will mean;

 

(2)  request that the guidance ‘‘working together at scale’ issued in August states that NHS Trusts, when seeking  to ‘reduce unwarranted variation' and ‘inequality in health outcomes’ is accompanied by clarity over the movement of resources;

 

(3)  request that Wirral is given a clear explanation of the implications of the plans to ‘ensure that specialisation and consolidation occur where this will provide better outcomes and value’;

 

(4)  request a financial forecast of the full context that Wirral will face as Edward Argar MP has stated ‘local systems will be informed of their resource envelope at the start of the year and will be required to agree a plan that matches, or is within, that envelope’, and demand an immediate halt to the rollout of ICSs until such a consultation and explanation has taken place; and

 

(5)  promote the introduction of legislation to bring about universal, comprehensive and publicly provided NHS and a Social Care System fit for the 21st century.

 

The Civic Mayor then adjourned the meeting at 9.12pm.

 

The meeting resumed at 9.20pm.