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April 12, 2013 by Protect Our NHS

Apologies for the delay in getting these minutes out. The day job got in the way.


Jenny Smith, Keith Evans, Mike Levine, Ben, Hilary Saunders, Barbara Smith, Steve Timmins, Ashley Langdon, Shaun Murphy, Pam Trevithick, Richard Henderson, Andy Burkitt, Don Kimber, Sara Halsey, Rhiannon Prys Owen, Margaret Hickman.

Mike Campbell

This time I have put Action Points at the beginning. The discussion at the meeting follows. I’m sorry it is so long but for the benefit of those who weren’t able to be there I think it is a very good insight into the role of the public in the new CCG system.

Action Points:

Meeting with Steve Williams MP at City Hall at 2.30pm 12th April to discuss why he is not supporting attempts to repeal Section 75 legislation. I.30pm meet at Woods Cafe on Park Street first.
Hilary, Ben, Keith, Sara, Steve and Barbara to meet at Robin Hood on 15th to plan for May 4th Demo.
Barbara to approach Steve Walker (http://skwalker1964.wordpress.com) with a view to him coming to Bristol at the end of May to give a talk.
Steve, Barbara and Mike to put list of relevant public meetings on the web site for Bristol and North Somerset and notify group
Continue to attend CCG Meetings and ask written questions in advance.
Prepare more questions for next CCG Meeting in North Somerset and Bristol.
Attend HealthWatch Meetings.
Attend Health and Well Being meetings and HOSP meetings.
Work with local and national charities to understand how individual patients are being treated. Provide evidence for Tara Mistry to take to the CCG.
Put pressure on the Labour Party to repeal the 2012 act if they get back in after the next election.

Tara Mistry Presentation
Tara Mistry: is the lay member responsible for Patient and Public Involvement (PPI) on the board of Bristol’s Clinical Commissioning Group (CCG), made a presentation to the group explaining how her new role worked. Tara reported that she would liaise with HealthWatch and she believes the CCG has sufficient resources to deal with patient and public issues. Her role involving governance and corporate responsibility is shared with Tony Jones, the salaried PPI manager and Steve Davies, a GP practice manager who also sits on the board. She sees her role as guiding/advising/raising issues and addressing those issues which arise as a critical friend.

Tara emphasised that the HealthWatch relationship was very important and that this is a key place for us to become involved. Bristol HealthWatch is run by the charity Care Forum who won the tender: http://www.bristol.gov.uk/page/health-and-adult-care/bristol-healthwatch. Tara believes that our involvement through HealthWatch would mean she was being challenged from the outside and can represent these views internally. She has been building links with the voluntary sector for many years and she feels that the relationship with the Council’s Health and Well Being board needs to be strengthened. Tara was very positive about the CCG board and believes that there is a strong feeling that it wants to preserve the NHS.

Pam thanked Tara very much for her presentation and opened the floor to questions.


Shaun: also thanked Tara. Having attended a CCG meeting that afternoon he agreed that the CCG board had sympathy for our position. He emphasised that our concern is to stop the NHS being privatised and asked what was the best way to influence the CCG. He noted Tara’s comments about HealthWatch and the Health and Well Being board, but was concerned about their relevance and powers in relation to this key question.

Tara: pointed out that it was her function to remain neutral on such matters, but believed that if we had this concern we should be challenging the procurement and tendering processes. Patient and Public groups are looking at this and a lot of this will happen through HealthWatch. She stated that it was clear that the CCG is keen to broaden the provider base. Anywhere, therefore, that there is poor performance the CCG will use it to seek alternative provision.

Keith: pointed out that the problem with HealthWatch is that you had to belong to a group to get on to it. He felt that they had had a very low key launch and that perhaps Patient Participation Groups (PPGs) would be a better possibility. Tara agreed that HW was not a panacea, but that it was a good route for us.

Margaret: raised the 111 issue. Harmoni has won the contract and it is not working. Harmoni has been bought out by Care UK which funded Andrew Lansley’s office. Organisations like Harmoni are not imbued with the NHS ethos. They spent years getting hundreds of contracts round the country in order to ensure they would be bought out by one of the big boys. Care UK has proved to be a disaster – not enough staff and huge pressure being put on ambulance staff. Organisations like Care UK do not care about people, they care about profit. Smaller private companies do care and are embedded in the NHS and we don’t object to them.

Tara: emphasised yhat if we felt strongly about this issue then we should keep raising it politely every time.

Steve: reported that the situation in North Somerset was far worse in terms of PPI as the Lay Chair is the PPI officer and is also a consultant to Capita Symonds. He had noticed at the CCG meeting how questions from councillors were being fobbed off with the excuse of “commercial confidentiality”. He asked Tara how we could access information about the procurement process if this was going to be a standard rebuttal.

Tara: advised us to continue to ask general questions about intentions to procure. Freedom of Information (FOI) Requests can sometimes be utilised.

Jenny: asked who, in the new system, is going to make FOI requests. She agreed that the Health and Well Being Board needs strengthening and that its agenda is to assess the health of the whole city. Can members of the group attend scrutiny meetings? She asked Tara if there are formal criteria for the public to examine specific elements in tendered contracts. Although Tara said that the whole process should be transparent, Jenny felt that the local authority is very transparent where the CCG currently is not. Again Tara emphasised that we should write in to get formal responses to which we could follow up.

Mike: felt that although he has a gut objection to privatisation many of the public don’t and they don’t realise it will lead to cuts. These will be cuts which happen under the radar. He believes it is one of our aims to inform the public of the cuts. We need, therefore, information desperately and need a co-ordinated approach to getting this information out into the public domain.

Tara: said that this was not within her remit. The CCG is only just getting to grips with commissioning. She is not able to get into everything.

Mike: asked whether, if she had had information on cuts, it was her role to raise it internally and was she able to explain the consequences.

Tara: responded that it was her role to challenge internally and defend the patients. She wants a structure whereby she can receive information from patients.

Richard: stated that the CCG constitution talks about a commissioning and procurement plan. When are they going to be published?

Tara: they have started consulting on commissioning, but in terms of procurement there is no plan.

Shaun: asked if Mental Health recommissioning is in progress. Keith reported that July is the start date for procurement for mental health.

Barbara: pointed out that at the end of the CCG meeting the public were dismissed due to confidentiality. Why was this?

Tara: said that it is called ‘reserved’ business and she would like to move to a position where there is no reserved business.

Jenny and Margaret: both emphasised the serious issue of bed blocking in Bristol. Margaret warned that UBHT could become like Weston unless this issue was addressed properly.

Rhiannon: enquired further about patient participation. We need to work with charities to find out what is happening to patients on the ground. We need small examples and evidence based information. Tara agreed.

Barbara: requested that the language of the CCG is complex business speak and that it would be very useful if the board could take note of that.

Tara: agreed that this was important.

Tara was thanked by Pam for her time and trouble on such a difficult day for her.

The meeting then discussed the issues it presented to our strategy. Ben asked if attending a few meetings and asking questions was all we could do. He understood that we had to move forward with what was being proposed, but wondered where 38 Degrees fitted in to all this. Keith agreed that private companies are fleet of foot and that organisations like HealthWatch could become absorbed into the system. Shaun, however, pointed out that Bristol CCG has a £500m budget and despite the privatisation push of the last five years, if you exclude the Emerson’s Green Hospital only 3% is being spent privately next year so 97% of Bristol’s budget is still NHS. We do, therefore, have plenty of time to watch for and scrutinise all private company tenders. Margaret suggested that we tap into the Patients Association – http://patients-association.com. Don felt that it would be helpful to build up a file of case studies we could take back to Tara Mistry. Pam agreed but emphasised that we had to protect our sources if it involved any kind of whistle blowing. Sara said that Ed Milliband was due to come to Bristol and the meeting agreed that we needed to put pressure on Labour both locally and nationally to stick to their private promises to repeal the 2012 Act. A sub committee was set up to plan for May 4th demo.

The next meeting of the group will be on 23rd at 7.30pm in the Robin Hood pub on St Michael’s Hill, Bristol.

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“That’s the standard technique of privatization: defund, make sure things don’t work, people get angry, you hand it over to private capital.” Noam Chomsky

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