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No planning Permission for New Hospital in Dover?


East Kent Hospitals University NHS Foundation Trust says it is planning to build a new hospital on the site of Dover’s present Buckland Hospital and claims the new hospital will cost £21,000,000. However, according to Dover District Council leader Paul Watkins the Trust has not yet applied for planning permission. What is going on? My attempts to find out raised more questions than they answered.

As well as being leader of Dover District Council, Paul Watkins is a member of the newly-formed Health and Wellbeing Committee, which will be run by, or has close links to, Dover District Council. To further complicate matters, there is also a South Kent Coast Clinical Commissioning Group. Trying to find information on how the roles of these various organisations interlink or overlap, or do not, seems depressingly difficult.

According to the Department of Health, the reorganisation will liberate the NHS leading to increased democratic legitimacy in the NHS. Yet the Health and Wellbeing Committee appears to have no democratic element at all as members are appointed and are not voted into office. This seems to have led to a committee dominated by ruling Conservative group councillors with no representation from representatives of other political parties. More and more interesting.

Now according to the South Kent Coast Clinical Commissioning Group, their role is to:

1. Prevent people from dying prematurely.

2. Enhance quality of life for people with long-term conditions

3. Help people to recover following episodes of ill health or after injury

4. Ensure that people have a positive experience of care

5. Treat and care for people in a safe environment and protect them from avoidable harm

and in addition to these

6. Tackle health inequalities.

OK, so these are the aims of the South Kent Coast Clinical Commissioning Group. What, then, are the aims of the Health and Wellbeing Committee? Not a lot, it appears. In fact, it will be wound up in 2013 and become the Health and Wellbeing Board. Confused? You are not the only one.

So if I do not know the role of the Committee, and it seems to late to matter now, what will be the role of the Board? According to Parliament’s Publications Website the role of the Board will be:

“Health and wellbeing boards will be the forum for local authorities, the NHS, local Healthwatch(?), communities and wider partners, to share system leadership of both health and care services and population health.

The Act mandates the statutory minimum membership for health and wellbeing boards to include at least one local elected member, a CCG representative, the local directors of adult social services, public health and children’s services, and a representative from the local Healthwatch organisation. The NHS CB must also participate when invited to do so.

They will develop a joint understanding of local needs through Joint Strategic Needs Assessments (JSNAs); a shared set of priorities and a strategy to address these in Joint Health and Wellbeing Strategies (JHWSs). JSNAs and JHWSs will form the basis of NHS and local authorities’ own commissioning plans, across health, social care, public health and children’s services. The Government recently concluded a short public consultation on draft statutory guidance on JSNAs and JHWSs. A formal response to this consultation will be published by the end of the year.

Health and wellbeing boards will have duties to encourage integrated working between commissioners of services across health, social care, public health and children’s services. This complements duties on CCGs and the NHS CB to promote integration. They will consider how the collective resources of the NHS and local government can combine to improve outcomes, for example through Community Budgets.

By involving local councillors and representatives of people using services through local Healthwatch, and through wider engagement with local communities, health and wellbeing boards will strengthen local democratic legitimacy of health services and increase the influence of local people.”

So, to complicate matters further, a NHS Commissioning Board will have statutory responsibilities for the South Kent Coast Clinical Commissioning Group. There will also be a group overseeing NHS provision for the public and its name will be Healthwatch. It will:

“… be the new consumer champion for both health and social care, and Local Healthwatch will feed local people’s views and concerns about local health and social care services into the system.”

Have you heard of Healthwatch? I hadn’t. Yet it’s supposed to be the service users’ champion.

I took a look at the membership of the respective groups, committees and boards. On the board of the South Kent Coast Clinical Commissioning Group are: Dr. Joe Chaudhuri and Mr Chris MacKenny.

On the Health and Wellbeing Committee are: Dr Joe Chaudhuri and Chris Mackenny. In addition I found Cllr Paul Watkins and Karen Benbow.

Among the Council of Governors of the East Kent Hospitals University NHS Foundation Trust is Karen Benbow.

And as I had confirmed before, the Leader of Dover District Council is Cllr Paul Watkins.

With the same people appearing on the same committees, boards and groups, wouldn’t you think that information regarding the work of one would be relayed to members of the others? Yet Cllr Paul Watkins, as Leader of Dover District Council, announced to the press that the East Kent Hospitals University NHS Foundation Trust had not contacted the Council’s planning officers over the building of the new hospital. Surely he must have known what the East Kent Hospitals University NHS Foundation Trust was planning through his contacts in other groups, committees and boards he serves on. Couldn’t he have had a quiet word with his friends on the other boards, groups and committees rather than appearing to slap down the East Kent Hospitals University NHS Foundation Trust in the press and potentially cause more confusion for the public? Keeps his name in the public domain, I suppose.

Or maybe other members of boards, groups and committees are not friends but potential competitors?

When do roles overlap and when must they be kept separate and private? How can so few individuals have seats on so many boards and groups? I thought this reorganisation was supposed to make the NHS more accountable and democratic? Sorry, but it seems far more complicated, less democratic and open to accusations of corruption and cronyism. Not that I’m accusing present members of being corrupt but the potential is there.

And where in all this bureaucracy and red tape do ordinary people, the users of the services, come? Do people actually matter any more? And, most importantly, how is all this reorganisation supposed to keep our NHS as a public service and keep it from becoming a money-making machine for private companies?


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