Please respond to the council's Health & Wellbeing Strategy consultation (deadline this Wednesday, https://ww5.gloucestershire.gov.uk/surveys/Health_and_Wellbeing_Survey/) 

BUT before you do... please read my response below.  I have heard from a number of 'insiders' that there are strong concerns that the Health & Wellbeing Strategy - which SHOULD be the way the council PROTECTS our health services - will be used to run them down, putting the blame for poor health on individuals to justify cutting services. See, for example, www.halfagiraffe.co.uk/2012/10/gccs-health-and-wellbeing-campaign.html.  We also noticed this when (with 38 degrees) we attended the recent health bosses meeting, where it was very obvious that the intention was to dress up cuts as 'increased personal responsibility'.  The questions in the consultation are highly misleading. If you care about our health service in Gloucestershire, please consider responding in a similar vein.  Hope this helps, feel free to use as much as you like.

My response follows:

How I responded to the Health & Wellbeing in Gloucestershire consultation, deadline Wed 12/12/12

Q1 Do you agree with the following statements –

I have ticked ‘strongly disagree’ to all the statements, except the last one, which I have ticked ‘strongly agree’.  This might seem an odd position, but it is the only way I feel safe answering this questionnaire - see how I responded to Q5 ‘any comments’-  the most important part of my response! 

Q2 What can individuals do to support their own health & wellbeing?

They need support to do so & there is little they can do if their living standards are being squeezed through cuts and benefit services, to the detriment of other services.

Q3 How can ‘communities’ work together to improve health & wellbeing in their area?

By insisting that councillors, council officers and health commissioners engage in proper democratic consultation - which this is not - and being much more transparant about who is making decisions, where, and when?

Q4 What can organisations in Gloucestershire (such as the County Council and the NHS) do differently to improve the overall health and wellbeing of people in Gloucestershire?

Councillors and the NHS must:

- ensure a strategy that doesn't dress up 'cuts' as 'empowerment' & 'personal responsibility'

- reject an emphasis on 'personal responsibility' which penalises and punishes the poorest, puts extra burdens on patients and carers, and fails to address the big business interests that push unhealthy lifestyle choices on us all

- give residents a real chance to have a say on the real issues - not through misleading 'consultations' which ask questions in a very leading way

- protect funding for services that make us healthier (parks, leisure & education), ensure better procurement of healthy food options,  introduce traffic calming measures to make exercise safer

ensure a strategy that focuses on the method of delivery & not just outcomes

ensure a strategy that protects our right to keep services publicly run, not tendered out to profit-making companies, which will just take money out of the system and lead to greater costs for individuals

ensure a strategy that has a strong stance to protect existing services

require  a strategy that has a presumption in favour of service improvement not tendering out - and a strong commitment to full public consultation before tendering is considered for any service

ensure that different parts of the NHS are not forced to compete with each other but prioritise co-operation

Q5. Any other comments

"I have had to reject the following suggestions, even though they sound harmless, because I do not feel this consultation is upfront about what the suggestions really mean, or how they will be used.

‘Supporting communities to take an active role in improving health’, ‘Encouraging people to adopt healthy lifestyles to stop problems from developing’, ‘Taking early action to tackle symptoms or risks’ 'Helping people to take more responsibility for their health’ – all these SOUND harmless but they should NOT be used to justify removing, running down, privatising or diverting money from services from those who are in need. 

'Helping people to recover more quickly from illness and return home' must not happen at the expense of ‘chucking them out of hospital prematurely’!

The current strategy is deeply flawed.  It reads like a cutter's charter.  In the current climate, if the council is to have a hope of holding decisions about our health to account, there must be a much stronger commitment to treating patients and service users on the basis of need, regardless of income, and providing the best quality care available, and giving the public the chance to collectively express a preference for NHS provided services."

Your Health, Your Care (the second part of the consultation, on the 5 yr strategy)

Again I have disagreed with many of the apparently harmless sounding suggestions because of what I feel they will be used to justify, and made the following comments:

Self care & Wider support - Community access to specialist help must not be used as an excuse to close down community hospitals.  There may be instances where centrally provided services are neccessary but patients should retain the choice to be treated as locally as possible and specialist services in local hospitals and clinics should not be withdrawn without full public consultation and detailed, transparant consideration of the clinical implications.

How we might  measure the success of our vision – Again, these questions are very leading and meaningless.  Rather than look to justify outcome measures which are far too vague, the strategies should focus on supporting the ethos of public service provision, avoiding constant reorganisations and expensive tendering.

Any other comments - Yes, there is much more that needs to be done before any changes can be considered to have been properly consulted upon.  This consultation is extremely poor.  The implications of changing the location, provision or funding of care have barely been touched upon.

Press Release – Stroud Against the Cuts – 15/10/12 – for immediate release

Gloucestershire’s Community Hospitals to stay in NHS –outsourcing decision reversed

Today Gloucestershire NHS campaigners were celebrating victory as Gloucestershire Primary Care Trust

announced that the county’s 8 community hospitals and health services (including 3000 nurses and other health

workers[1]) would remain in the NHS – reversing an earlier decision to outsource services, in what would have been

the largest such transfer in the country.  The board of NHS Gloucestershire voted today to create a new standalone

NHS Trust [2], and to reject the option of opening health services up to private sector bids.  Locally this means staff

and hospitals will remain wholly part of the NHS. At a time when many NHS Community health services elsewhere in

the country are being tendered and taken over by private companies like Virgin and Serco [3, 4], and when concern

about the consequences of the recent NHS Act is increasing at the highest levels [5], it is also a decision with

significant national implications, and the first decision of its kind.

The decision follows a hard-fought 18 month campaign by anti-cuts campaigners across the county, including a

High Court challenge against the Primary Care Trust’s outsourcing plans by 76 year old Michael Lloyd of Stroud,

who argued that NHS options for services had not properly been considered.  Lawyers acting for Mr Lloyd obtained

a court order in February 2012 [6] halting the proposed outsourcing and requiring NHS Gloucestershire to go back

to the drawing board and properly consider NHS options. In May, health ministers conceded [7] and the PCT

accepted [8] what campaigners had always argued - that creating an NHS Trust was an option, and that there was

no legal requirement on local health bosses to put services up for tender. The court order had also required NHS

Gloucestershire to consult staff and the public – consultations which resulted in 91% of staff, and 96% of the public

voting for the services to be run by an NHS Trust [9].

Michael Lloyd, a retired railway-man from Stroud, said “I am delighted by today’s decision. I can remember what

life was like before the NHS existed, and we cannot allow a return to the fear and poverty that ill health brought in

those days, and indeed still brings in the American market-based system.  Our NHS is too precious to be handed

over to anyone on a political whim, nor should it have to compete against private providers, who are only interested

in maximising their profits. The public, and the staff who provide my healthcare, should have been consulted in the

first place, so I’m very pleased that our voices have been listened to at last.”

Caroline Molloy of Stroud Against the Cuts said “This is a triumph for people power, and the outcome we’ve worked

for from the start. We would like to pay tribute to the tens of thousands of people across Gloucestershire who have

contributed to this victory for our NHS, whether by marching, filling in consultations and petitions, attending

meetings, contributing financially, or helping the campaign in countless other ways. We also owe a huge debt to the

brave members of staff and trade unionists who spoke out, to the national campaigners like Keep Our NHS Public

who have supported us, to the legal services commission who made the court case possible through legal aid

funding, and most of all to Mr Lloyd, without whom, all these NHS staff and local hospitals would have already left

the NHS. We were told over and over that there was no alternative to outsourcing our hospitals – but today we’ve

proved that to be false. We’ve also shown that despite statements to the contrary, competitive tendering out of the

NHS isn’t compulsory, and that local health bosses retain discretion to keep all services in house.”

”

Claude Mickleson of Forest against the Cuts added “We know that the NHS still faces wider threats, both locally and

nationally, with widespread attempts to privatise, cuts staff numbers and to lower pay.  We will need to be vigilant –

but we will be better able to resist future attacks now that we have won this battle.  We hope today’s outcome makes

everyone – including the Clinical Commissioning Group who will soon take over decision making in Gloucestershire -

realise that when the principles of a free, publicly owned NHS are under attack, people can and will stand up protect it.”

ENDS
For more info please contact Caroline Molloy 07931 302507

Notes for Editors
[1] The services affected are eight community hospitals (Stroud, Cirencester, Dilke, Fairford, Lydney, Moreton,

Tewkesbury, and the new Vale Hospital in Dursley) and nine health clinics (Beeches Green Stroud, Stonehouse

Health Clinic, Cinderford Health Centre, Coleford Health Centre, Lydney Health Centre, Hesters Way Healthy Living

Centre, Holts Health Centre Newent, Lydbrook Health Centre, Symn Lane Clinic), as well as District Nursing, Health

Visiting, Podiatry.

[2]As the Health & Social Care Act 2012 abolished Primary Care Trusts with effect from April 2013, the PCT’s

‘provider arms’, ie community services, have had to find new homes.  In most of the country these services have

been housed in other NHS Trusts, but across the South West there was a widespread move to outsource to

non-NHS providers, a move that started under the ‘Transforming Community Services’ programme introduced by

the last government.

[3] http://www.telegraph.co.uk/news/features/9193015/Healthy-competition-in-the-NHS-is-a-sick-joke.html

[4] http://www.bbc.co.uk/news/uk-england-suffolk-19786652

[5] http://www.guardian.co.uk/society/2012/oct/13/david-nicholson-fears-nhs-reforms

[6] http://www.nhsglos.nhs.uk/2012/10/nhs-gloucestershire-nhs-swindon-board-papers-for-october-15th-2012/ see appendix 2 for court order

[7] http://www.whatdotheyknow.com/request/exchanges_between_doh_and_glouce in particular, see second letter from Department of Health to Geoffrey Cliften Brown MP (attachment 701443), dated 21^st May.  There had been earlier misunderstanding about the need for tendering in some quarters, see for example: http://www.stroudnewsandjournal.co.uk/news/9655101.Stroud_MP_Neil_Carmichael_refuses_to_join__Keep_NHS_public__campaign/

[8] See for example http://keepglosnhspublic.posterous.com/communication-from-the-board-of-nhs-glouceste letter from Jan Stubbings dated 16 May (scroll down)

[9] http://www.nhsglos.nhs.uk/2012/10/nhs-gloucestershire-nhs-swindon-board-papers-for-october-15th-2012/ appendix 3 (staff consultation results), app.x 5 (public consultation results)