Minutes of the meeting held at Birmingham Midland Institute 26th April 2014
Present: Robert Buckley, Richard Bourne, Doug Naysmith, Sarah Edwards, Alex Fraser, Gavin Ross, Tony Beddow, John Lipetz, Brian Gibbons, Katrina Murray, Richard Grimes, Tony Jewell, Judith Varley, David Pickersgill, Chris Bain, Joe Farrington-Douglas, Peter Mayer, Hannah Cooke, Philip Hunt, David Mattocks, Brian Fisher.
Before introducing the Agenda the Chair stated that it was important to spend significant time on policy discussion.
Agenda of the meeting, and documentation
1.Apologies
Received from Councillor Sanchia Alasia; Steve Adshead; David Amos; Rehana Azam; Jos Bell; Barrie Brown; Tom Fitzgerald; Brian Flood; Patrick French; Vivien Giladi; David Taylor-Gooby; Melanie Johnson; Matthew Prior; Shibley Rahman; Alison Scouller; Alan Wenban-Smith; Patrick Vernon; Eric Watts
Apologies were accepted
Members present then introduced themselves
2 Minutes of Central Council on 18th January 2014
Matters arising:
2d) It was felt to be unclear whether the paper on Public Health had been adopted as SHA Policy. Clarification needed.
2e) There was discussion about whether the Secretary was responsible for the actual conduct of the election ballot. It was not possible to ascertain the Secretary’s understanding of the arrangements as he was not present
3 Matters remitted by the AGM
3.1 Procedure for managing complaints, grievances and discipline
There were concerns that the Procedure conflated a policy for members to access and one that applied to the Central Council as an employer.
There also concerns about the wording “Abuse of drugs or alcohol”
It was proposed that the wording under Major Allegations should be amended to “Impairment of performance due to the abuse of drugs or alcohol”. This was agreed.
It was proposed that the parts of the policy that related directly to the Central Council as employers should adopted. This was agreed.
It was proposed that the policy relating to members should be remitted to Officers for further consideration. This was agreed.
3.2 Resolution from Weaver Vale CLP
There are a number of closely related issues not referred to in the motion. Funding cuts; loss of specialist inputs; cuts in Local Authority services; the relationship between parity of esteem and the integration of services; safe staffing levels; the knock on effects of cuts in Mental Health services on medical services.
The broad thrust of the resolution was agreed, although the other related issues needed to be included in an SHA response.
3.3 Affiliations
It was proposed that all affiliations be agreed with the exception of the NHS Alliance which should be reviewed. This agreed.
It was also agreed that all affiliations should be reviewed annually. As part of that review we could draw the distinctions between political and non political affiliations
It was also agreed that the SHA should be a signatory for the National Coalition for independent Action
3.4 Report from the Labour Party Special Conference (1st March)
The NEC recommendations were accepted. This means that SHA members will lose their additional vote in Leadership elections. There are to be fees for Union members to become “Supporters”, it is questioned whether this is cut price deal for membership? The response may be that your rights as a “Supporter” may be different to those as a “Member”.
3.5 Nominations to the Labour Party
There were none
3.6 Labour Party Constitutional amendments
There were none
4 Election of Officers (Vice Chairs)
It was proposed that there should be one vice chair. This was not agreed.
It was proposed that there should be two vice chairs. This was not agreed.
Therefore the current position of four vice chairs remained. It was proposed that Melanie Johnson, Richard Grimes, Brian Fisher, and Tony Beddow be elected as vice chairs. This was agreed en bloc.
The role of vice chairs now needs to be clarified
5 Future meetings
Dates of Central Council meetings agreed. The date of the AGM to be considered at a later date.
Policy discussions
The purpose of the policy discussion was to enable the SHA to influence the Labour Party policy document.
Cllr Steve Bedser, Birmingham City Council:
An understanding of the impact of health inequalities are the key to developing an effective health policy. 1 in 4 10 year olds are obese and will be systematically excluded as they go through life.
Organisational restructuring is not the answer, it is more likely to lead to inertia. Far better to simplify cash flows and governance arrangements in health. Look at the wider determinants of health and at public engagement
We need a national consensus on adult social care. The tensions between health and social care need to be effectively managed.
The NHS seems rudderless and leaderless. Commissioning is fragmented and lacks the strategic dimension formerly the responsibility of the Strategic Health Authorities.
Do we need to get rid of the artificial purchaser/provider split?
Is it all about how we deliver services?
Do we need to study the Welsh and Scottish experiences?
Should our priority be to improve poor primary care in disadvantaged areas? Or at least to address the inconsistencies? Is the instinct of the NHS to cover up poor care?
Is there any clear evidence that commissioning actually improves outcomes? Or is commissioning ideologically based and values driven? Would it be better to make a clear statement of principle on commissioning and get rid of the flawed internal market entirely? Does the planning function need to be entirely separated from the vested provider interests?
Should we be focussing on concepts such as social capital to improve outcomes and accountability?
Richard Bourne’s email suggestions of 17th April 2014
Set out 5 key points, namely:
1) To restore the duty of the Secretary of State – to deliver a comprehensive system and to have powers of intervention in any part (including Foundation Trusts).
2) To replace the market based commissioning/procurement system with one which plans the delivery of integrated public services in a democratically accountable manner, removing all legal and organisational barriers to collaboration and cooperation.
3) To progressively move to a system where personal social care is free at point of need, as with healthcare – removing the artificial distinction.
4) To develop an integrated care workforce plan and to implement (after consultation) including the workforce related recommendations from Oldham and Kingsmill and the Unison Charter for Care.
5) To commit to working to develop a 10 year plan for care based on as wide a consensus as possible and to set out within a year how to fund a modern comprehensive care system.
The meeting agreed these were useful, and wanted to add an amendment “The budget will have to recognise that it will cost an increasing proportion of GDP”
The meeting also agreed that we should work to get health at the heart of all Labour Party policy. It was also important not to exclude Public Health considerations.
10 Suggested amendments to health policy (Brian Fisher)
The meeting considered the 10 amendments.
A commitment to community and individual participation
Promoting more patient involvement through Healthwatch? Reintroduce CHCs? Find better ways of dealing with patient and family complaints and the need for advocacy. The problem is that local Healthwatches vary in approach and in performance
No marketisation, no privatisation
Are some parts of the system not fit for purpose? Does the influence of lobby groups need to be looked at carefully? Are there influencers who may be useful to us?
What does the Labour Party need to do in the very short term? Does the Party need to draw a line in the sand? Should we keep away from radical restructuring, perhaps review the functions rather than the structures?
The meeting agreed that there should be no top down restructuring, but recognised the need for local determination in finding ways forward.
Should we be targeting what the Tories have handed over to the private sector as one of our key campaign messages?
- Incentives for cooperation for better outcomes
Should financial processes promote cooperation, or should cooperation be based on incentives? Should payments be linked to outcomes?
- Invest in the NHS
Agreed
- Invest in community care, including general practice
Should GPs be salaried? Should be moving towards it? How would increased investment integrate with Acute Care and Social Care?
- Social Care free at the point of use
Agreed, although issues around definitions and eligibility remain important
- Integration
Agreed, although the social model of disability needs to be incorporated within the amendment
- Public health that tackles the social determinants of health
It might be useful to resurrect Richard Wilkinson’s ideas about the inequalities of power in society and incorporate them into this amendment
9 Tackling health inequalities
Agreed
- Support NHS Staff
Agreed
There was also a motion to defer consideration of the documents “Where now for the SHA” and “SHA Call for Action” to a future meeting of the Central Council when the agenda permitted.. This was agreed.
Meeting closed at 3.15pm