So, what’s it all about?
With over 200 Clinical Commissioning Groups set to take over the commissioning of services from April, it will be incredibly hard for the public and health workers to know what’s happening with regard to their services in time to do anything about it effectively. Whether or not the government’s ‘Section 75’ resolution goes through, CCGs will be under pressure to include private providers in the provision of services, and private providers will already be working hard to gain influence over CCGs. It will be extremely difficult for activists to have a clear picture of what’s going on, let alone to co-ordinate action.
However, the NHS Constitution gives statutory rights to patients and public, and places specific, statutory duties on NHS bodies. The rights include:
- to be involved in discussions and decisions about your healthcare, and to be given information to enable you to do this. (NB: not just treatment, but wider healthcare)
- to be involved, directly or through representatives, in the planning of healthcare services, the development and consideration of proposals for changes in the way those services are provided, and in decisions to be made affecting the operation of those services
In addition there are (non-statutory) commitments that form part of the constitution. These include a commitment “to provide you with the information you need to influence and scrutinise the planning and delivery of NHS services (pledge); and to work in partnership with you, your family, carers and representatives” and “to engage staff in decisions that affect them and the services they provide, individually, through representative organisations and through local partnership working arrangements.”
The document also places expectations on anyone working within the NHS:
- to play their part in sustainably improving services by working in partnership with patients, the public and communities
- to view the services they provide from the standpoint of a patient, and involve patients, their families and carers in the services you provide
Based on these rights, duties, commitments and expectations, I believe that it will be possible for the right person or group to:
- engage with local communities and unions to be named as a ‘representative’ to allow a legally-underpinned interaction with CCGs
- require of CCGs to provide timely information on any plans to change how services are provided, especially details of planned tenders or approaches to the AQP marketplace
- work with local communities and unions to demand representation on the CCG and involvement in both discussions and decisions about awards of contracts to provide NHS services
- demand that ‘best value’ is applied in its widest sense of long-term sustainability, public ownership, community impact (through lost wages and restricted services due to private companies taking a profit margin etc) and the retention of public NHS personnel and infrastructure that, if lost to a private provider, will be very hard ever to reacquire or rebuild
- provide a central, easily-accessible source of information for individuals and community action groups to know what their CCGs are doing or planning and a partnership to help co-ordinate the above actions
- challenge awards to non-public entities
The aim of CCGWatch, if I can get it off the ground, will be to:
- provide a central repository of information on CCGs’ plans and tenders/FOI requests
- build contacts with local unions, activists and residents to engage them in the decision-process
- contact every CCG to remind them of their statutory duties and to require them to provide information on their plans, tenders and any conflicts of interest
- publish details of plans, tenders, invited bidders and decisions
- co-ordinate resistance to the transfer of services to private providers based on the information obtained as a legal right
The key thrust of the project is aimed at CCGs as the name suggests, but the same principles could apply to other threats to services as well.
Obviously it’s going to be a big job, so all help is appreciated! If you can help finance this it would be helpful.Any questions or issues, please let me know, otherwise I look forward to hearing about the next steps we can take.