11 Nov 2018

NHS privatisation: Letter to the press

Following my recent work in highlighting the threat of creeping privatisation in the NHS and Wirral Council's complicity in this, the following letter has been published in both the Liverpool Echo and the Wirral Globe:


On October 16th, Wirral Council and NHS Wirral agreed to establish an Integrated Commissioning Hub. Wirral's Clinical Commissioning Group will be using it to procure a range of NHS services from April 2019.

This rather mundane sounding agreement has huge implications for health services in Wirral. The background papers confirmed that this agreement "will facilitate the introduction of a wider Accountable Care Organisation across the Wirral." Accountable Care is widely recognised as a means of facilitating privatisation within the NHS.

Currently, in most NHS contracts a needs-based payment is made for each treatment provided to individual patients. But the new contract would pay the provider a fixed lump sum at the start of each year, to cover the costs of a range of treatments for the whole population. This switch from a needs-based payment to a fixed contract is crucial. It means the introduction of rationing for health services. Fixed capital budgets will be allocated which are no longer based on clinical need and must not be overspent.

Despite warnings from myself and others, Labour councillors have chosen to proceed with this agreement. As the campaign group Defend our NHS has said "Members of the DONHS executive are alarmed that Labour councillors have defied their own party policy and voted to open the door even wider to the privatisation of health services in Wirral".

It is clear that the Conservative government is working to privatise by stealth our treasured NHS. It is deeply worrying that Labour councillors in Wirral have helped to facilitate this.

15 Oct 2018

Why is Labour helping to privatise the NHS in Wirral?

update: you can watch my speech via this link starting at 2.37.50

At tonight's full council meeting, a Labour party motion opposes the current closure threat to walk-in health centres across Wirral and explicitly states: “This council is opposed to all forms of privatisation in the NHS”,
 
Tomorrow, October 16th, a meeting of the Joint Strategic Commissioning Board for Wirral will consider a proposal to approve an Integrated Commissioning Hub for Wirral.  This will be opening the door to an accountable care organisation and health privatisation in Wirral.

I've tabled an amendment to Labour's motion asking council to specifically reject plans for an Accountable Care Organisation. These are my reasons why:

I welcome the very clear statement in this motion which states: “This council is opposed to all forms of privatisation in the NHS” and earlier public statements by the Leader of the Council that he opposes the development of an accountable care system in Wirral. Accountable care is widely recognised as a means of facilitating privatisation within the NHS.


Sadly, if the proposals for an Integrated Commissioning Hub for Wirral Council and NHS Wirral in front of tomorrow’s meeting of the Joint Strategic Commissioning Board (agenda item 6) are adopted then this council will in fact be opening the door to an accountable care organisation and health privatisation in Wirral.

There can be no ambiguity about this.  Throughout the associated due diligence report from Price Waterhouse Coopers there is reference to the development of an Accountable Care System and that the Integrated Commissioning Hub is the first step towards this. Crucially, the report concludes by saying:


Significantly, the publication of this all-important due diligence report was repeatedly denied up until a few weeks or so ago. No meaningful and proper public consultation and engagement has taken place. The public has been locked out. This is unacceptable and undemocratic.

If this contract goes ahead, our Clinical Commissioning Group will be using it to procure a range of NHS services from April 2019. 

Currently, in most NHS contracts apart from mental health, a needs-based payment is made for each treatment provided to individual patients. But the new contract would pay the provider a fixed lump sum at the start of each year, to cover the costs of a range of treatments for the whole population.

This switch from a needs-based payment to a fixed contract is crucial. It means the introduction of demand management and rationing for health services. Fixed capital budgets will be allocated which are no longer based on clinical need and must not be overspent.

This is a clear route to new “care models” that are based on the USA’s Medicare/Medicaid system that provide limited health care for people who can’t afford private health insurance.

A new government would be powerless to stop and reverse this because the contracts would be locked in for a continuous period of up to 15 years or more. 

And, we already know how this model operates. In mental health, the introduction of fixed lump sum contracts means that it is now normal for there to be NO hospital beds for acute mental health patients in their own area. They are routinely taken by ambulance across the country to wherever there is a hospital bed. 

This is not a model we should be rolling out across the health service. A model that allows for price competition between providers when bidding for contracts leading inevitably to a reduction in the quality of care and, potentially, a Carillion type collapse.

And, even if an Accountable Care Organisation is initially kept within the public sector it would still decimate the founding principles of the NHS. ACOs represent the breaking up of a single national health service into sub-regional care packages with fixed budgets and rationed services. This means a loss of universalism, comprehensiveness, national terms and conditions and quality standards.

Let me finish by repeating the all-important concluding sentence from PWC’s due diligence report:

The introduction of an integrated commissioner with a single pool of funds will facilitate the introduction of a wider Accountable Care System / Accountable Care Organisation across the Wirral.

There is no legislation in place forcing these changes on Wirral. The changes are entirely voluntary. In fact, if the clear statement in this motion – “This council is opposed to all forms of privatisation in the NHS” means anything then we must say an emphatic and resolute no to Accountable Care in Wirral.

I therefore urge all councillors to support this amendment and send a clear message to the relevant cabinet members that they must not support the proposals for an Integrated Commissioning Hub in Wirral and must not sign this legally binding contract.

11 Sep 2018

Wirral's green belt: under threat from Labour

Last night there was a special council meeting on the threat of wide scale development on Wirral's green belt. Below is a copy of the speech I delivered. You can also watch it via this link starting from 52 minutes in.


The threat to Wirral's Green Belt

Green Party response to full council meeting, September 10, 2018
I know I speak for many when I say how grateful I am to Professor David Gregg for the work he has done in interrogating the government's assessed need for housing in Wirral over the next 15 years.

He has systematically demolished the assumptions used to generate these targets, especially those around the economy and population trends.

Moreover, the very latest population projections dramatically reduce the likely demand for new housing in Wirral. Professor Gregg has shown that the council's own forecasts for brown field housing on top of Peel Holdings medium range expectation for Wirral Waters plus a modest reduction in our many empty homes is more than enough to meet likely future demand.

His analysis on its own provides compelling evidence to robustly challenge the government's target.

And that is the least the people of Wirral should expect from those elected to represent them and preserve our precious green belt.

But that's not what we are getting and, frankly, this council has form when it comes to undermining the green belt.

As we speak, a new fire station is under construction on green belt land in Saughall Massie. The fire services' own figures as part of that planning application clearly showed that response times from the new station would, on average, increase

If labour councillors are prepared to sacrifice green belt for a new fire station in a sparsely populated village that increases emergency response times then they clearly have a very elastic view of what constitutes "very special circumstances".

And then there is the proposed golf resort in Hoylake. The economics of this scheme are so questionable it requires 160 executive homes on green belt land. If the cabinet thinks council tax receipts from these new homes is reason to sacrifice our green belt then people will quite reasonably form a view that no green belt land is safe under this administration.

If the monies already spent on the golf resort had instead been spent on vital infrastructure for Wirral Waters then we would be much further down the road in providing the kind of new housing that everyone in Wirral would support. 

Don't forget our empty homes and commercial buildings
Officially, Wirral has 4.650 empty dwellings. Almost 2,000 of these are classed as "long term". But this is an underestimate. I regularly report empty properties in my ward. Many are unknown to the empty properties team. 

I have nothing but praise for the empty properties team. Their response to my enquiries is always constructive and comprehensive. But, with just three full time members of staff there is clearly massive untapped potential to reduce the number of empty properties. This should always be a priority to increase the housing stock. Additional investment can be recouped through increased council tax never mind the obvious social benefits.

And its not just empty dwellings. Last year, Wirral Council submitted planning applications to demolish two of its own office blocks by Hamilton Square and convert them into car parks. Just what Birkenhead doesn't need. One can only hope the new arrangement with Muse will bring more enlightened thinking and recognise the obvious potential to convert such assets into new residential accommodation.

The government's targets are unreasonable and unrealistic
The rate of housebuilding required under these government targets is more than double the actual delivery rate in Wirral over the past decade. Where is the evidence that underlying market conditions indicate such a rapid escalation in demand for new housing? How on earth would the supply chain cope with such a rapid escalation in construction activity?

We already have some of the worst standards for new homes in the EU. Our new homes are smaller and colder than our European peers. If these targets are accepted and implemented we will inflict acres of low quality, high carbon housing, with poor access to public transport. Few if any of these houses will be affordable to those on low incomes.

A council truly concerned about climate breakdown, poor air quality and inequality in housing provision would react with horror at these targets. They would mount a principled, reasoned and robust defence of our green belt. 

All of that is absent from the Labour motion. It raises the white flag and meekly accepts the surrender of our green belt. 

For the sake of our current and future generations that simply isn't good enough.

22 Jul 2018

Claughton Road flat conversion rejected as "unacceptable"


At this week's planning committee, I brought forward an application to convert an end-of-terrace property on Claughton Road into three flats. I did this because I strongly believed the proposal was an over development of the site. In particular, squeezing two flats into the first floor was unacceptable and would create very cramped living conditions for any future residents.


I was pleased the committee agreed with me and voted unanimously to refuse the application.

I am very concerned that Wirral's failure to adopt minimum room sizes is preventing officer's from refusing applications like this. I made this point forcefully during the debate and I will continue to press Wirral Council to address this and do more to stop a race to the bottom in living standards for private sector tenants.

 You can read my speech below and watch the debate via this link (starting at 2.05.50).

APP/18/00324 – 276 Claughton Road, Birkenhead

This traditional end of terrace property is located opposite the former Cole Street School. It is already operating as two flats despite having no planning history and is known to the council due to previous reports of anti-social behaviour.
I have three main concerns about this application. Two of these relate to the first-floor plans which would see this floor split into a one bedroom flat plus a studio flat.

Firstly, and as noted in the officer's report, the Private Sector Housing Team has raised concerns about the size of the studio flat. Specifically:

In relation to the 1st floor (rear) studio flat the combined floor area is approx. 16m2 (excluding the bathroom and lobby). Having viewed the Housing Act 2004 and the Housing Health and Safety Rating System, I can advise that this flat would be deemed too small to be considered an adequately sized unit of living accommodation.
The closest floor area to that being suggested for a self-contained flat is contained in a CIEH (Chartered Institute of Environmental Health) document, which provides for:-

One person flatlet with separate kitchen
Bed/Living room                               14m2
Kitchen                                                 5.5m2
Total habitable floor area             19.5m2
 Alternatively
 One person flatlet with separate bedroom
Bedroom                                             7m2
Kitchen/Lounge                                14.5m2
Total habitable floor area             21.5m2
 Bathroom and lobby floor area are not counted from a housing perspective.

So, the CIEH recommended minimum size is this type of flat is 19.5m2 and what we have here is 16m2.

Secondly, the one-bedroom flat on the first floor includes an extremely small bedroom – just 5.1m2. 

Bedroom 2 of flat 2 measures 5.1 square metres and is approximately 1.98m wide.  The government's technical housing standards require that: 

in order to provide one bedspace, a single bedroom has a floor area of at least 7.5m2 and is at least 2.15m wide.
A link to the standards is here:

Now from the case officer's point of view, the concerns raised by the Private Sector Housing Team relate to non-planning related legislation while the government's technical housing standards can only provide a guide line. As the officer's report says:

At present, Wirral Borough Council does not, as local planning authority, have adopted policies that regulate the size of rooms within new dwellings, including those formed through conversion. Nonetheless, the applicant's agent has been informed of the concerns raised by the Private Sector Housing Team. 

Now the way I read that is the officer telling us, as councillors, to adopt a policy that gives officers the ability to refuse applications like this. We now have a long and considerable case history of refusing applications for reasons of inadequate bedroom size with mixed results in terms of subsequent appeals. It's totally unacceptable that we have failed to address this issue and it has to be a priority in terms of the new local plan.

My third concern is that the outside amenity space is simply too small to meet the conditioned requirement for bin and cycle storage.

I would therefore suggest the following wording to refuse this application: 

The development proposed, having regard to the size of the building and by reason of the number of units proposed, would result in an over-intensive use of the building resulting in cramped and unsatisfactory living conditions that fall short of the good standard of amenity for occupants of buildings sought by Paragraph 17 of the National Planning Policy Framework.