HEALTH chiefs have been accused of adopting a ‘culture of secrecy’ amid plans for significant changes to the county’s health and care system.
The creation of ‘secret’ committees and behind-closed-doors workshops hosted by the county’s Health and Wellbeing Board (HAWB) have led to fears about a lack of proper scrutiny of the decisions being made.
Particular concerns over ‘back door’ privatisation have been raised by some councillors and campaigners following the decision to develop an Integrated Care System (ICS) in Oxfordshire – a decision made away from the public eye and set to be put in place by April.
Health chiefs have however boasted the newly-formed Integrated System Delivery Board (ISDB), a sub-committee of the HAWB which does not meet in public, has allowed for rapid improvements to the system.
Such improvements include the appointment of a system-wide winter director and the swift progression of an action plan designed to improve joined-up working across health and social care – a response to a damning report by the Care Quality Commission in February.
The ICS would see NHS organisations work in partnership with local councils and others (including private health providers) to take collective responsibility for the health of the population.
Speaking at a recent meeting of the Health and Overview Scrutiny Committee (HOSC), Didcot town councillor and member of the Keep Our NHS Public campaign group Cathy Augustine slammed the HAWB’s ‘policy of secrecy’.
She said: “We are deeply alarmed that the ISDB, the main driver behind the proposed ICS, is buried deep in the structure and virtually invisible from the scrutiny of elected representatives – meeting in secret and producing no public minutes.
“The HOSC itself is likely to struggle to fulfil its duties with all these opaque layers of the Health and Wellbeing Board.”
The make up of the HAWB, which plays a big part in setting health and social care policy in Oxfordshire, also prompted concerns at HOSC following a significant restructuring in May
The board now consists of 11 non-elected officials and just five elected councillors.
Oxfordshire county councillor Hilary Hibbert-Biles said: “I have serious concerns and I understand why people are talking about transparency.”
HAWB vice-chairman Dr Kiren Collison argued that the private workshops and sub committees allowed members to get to know other members on a ‘deeper level’ and facilitated swifter decision making.
She added: “Meeting just in public isn’t the best way to do things, it’s quite a difficult environment to get to know people, sometimes, so because of that we need to meet in workshops.
“We’ve got quite a long way in a relatively short period of time.”
Kate Terroni, director of adult social care and member of the HAWB, offered reassurance over the ICS saying: “It is not an organisation, it’s a description of how we work together and how to integrate the pathways to deliver for patients and the public.”
However, NHS campaigners have labelled the ICS way of working – which the NHS is expected to roll out as part of its 10-year plan – as merely a rebranding of the unpopular Accountable Care Organisations (ACO), which bring together several providers under one ‘umbrella’ to take responsibility for the cost and quality of care.
In 2016, a leaked letter revealed such plans for Oxfordshire with Oxford University Hospitals NHS Foundation Trust, Oxford Health NHS Foundation Trust and GP Federation OxFed, planning to create a ‘supertrust’, in place of the current model which sees the Clinical Commissioning Group hold the purse strings.
The plans though never came to fruition.
After the meeting Ms Augustine remained unconvinced however, branding the HAWB as ‘opaque and complex’ which left it difficult for members of the public, and indeed the HOSC to figure out what was going on.
Speaking about the plans for the ICS she added: “They said it doesn’t matter what the ICS is called all we need to know is that the principle of this way of working has been accepted at a national level – this way if working means privatisation.
“It means putting contracts out for 15 years, we’ve all seen Carillion and how they treated their staff.
“If it’s this principle it is a shoddy principle.”
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