Agenda item - Formal Public Involvement

This is the part of the meeting when members of the public can formally ask questions of the Board or present a petition.  These need to be notified to the Board in advance of the meeting.  Ring the Secretary to the Board, Mark Wall on 01273 291006 or send an email to mark.wall@brighton-hove.gov.uk

29A   Public Questions

29A.1                                      Mr John Kapp asked the following question:

          “Do the councillors on the HWB accept responsibility for the CCG being judged inadequate, and what plans have the HW B to help restore the CCG to being fit for purpose?”

29A.2The Chair responded that “the HWB is a partnership body, bringing together the city council, the CCG, NHS England, the city independent Safeguarding Boards and Healthwatch. The HWB is responsible for overseeing health and social care services for city residents, and for directing joint CCG and council working.  The CCG has plans to improve its performance, and some of these plans, particularly where they involve joint working, may be overseen by the HWB.

However, the HWB is in no way responsible for the CCG. The CCG is an autonomous organisation whose accountability is to the NHS regulators rather than to the HWB or the city council.”

29A.3Mr Kapp asked a supplementary question: “How can you say that the HWB is not responsible for the CCG when the HWB’s Terms of Reference states that the CCG is accountable to the HWB?” Natasha Watson (BHCC legal representative) replied that a previous similar question had received a comprehensive response and that this would be forwarded to the questioner. In brief however, although the HWB can hold the CCG to account, it controls neither CCG budgets nor appointments, and must act within the national legislative framework.

29A.4                   Mr Ken Kirk asked the following question:

“I am appalled at the prospect the inevitable cuts that STP will bring to the NHS.  It will result in drastic reductions is NHS services, involving ward closures, removal of entire services, yet more decreases in hospital bed numbers. No longer can this be disguised as mere service reconfiguration – we know and surely you know that the NHS will no longer be a comprehensive health service. You are our representatives charged with the responsibility to oversee the health services for the people of B&H.  Do you agree that you shouldn’t in all conscience connive with this decimation of our NHS by effectively demonstrating your rejection of STP?”

29A.5The Chair responded that “It is simply too early in the STP process to judge whether its impact on health services for local people is going to be negative as we haven’t even begun detailed planning. It would therefore be unwise for the Board to make a judgement without knowing all (or in fact any) of the facts.” The Chair added that, although he did not wish to contemplate withdrawal from the STP at this point, this did not mean that he did not have concerns about the process. The HWB will act in the best interests of Brighton & Hove, but can only come to a position when detailed planning is available.

29A.6Mr Kirk posed a supplementary question, asking whether the HWB would oppose increased contracting with the private sector, which he identified as an inevitable consequence of the STP. The Chair responded that it is still too early to judge with any certainty what the consequences of the STP will be. However, the STP is very likely to lead to greater integration between services, and much of this should lead to positive outcomes, as in the recent successful council and CCG co-working on Special Educational Needs and Disability (SEND) services.

29A.7          Mr Matthew Greener asked the following question (Mr Greener was unable to attend in person):

“I have a question for the chair in respect of the CCGs tender of the mental health service.

As I understand the situation the CCG issued tender documents on or about 16th August merging both Adult & Young Persons services & that the bidders will have 8 weeks to compile & submit their bid.  I am not confident that the CCG has given sufficient time or information for robust bids to be submitted, or for them to stress test or mitigate risks within this process.  I would expect the CCG to provide history data over a number of years for each condition to be treated or service to be provided so that bidders can at least ascertain any trends & growth - providing only projected growth of population would be useful only if it could be correlated against the historic data & included projected growth within each age group. 

Without this information the bidders will in effect be bidding blind and it is these bids against which the CCG will award the contract. Since by the nature of the tender there will be at least one new provider, can the chair confirm that the CCG has given the relevant useful data to the bidders and that they are confident there is time within the 8 weeks for meaningful and comparable bids to be submitted so that the CCG can satisfy itself that the bids meet the acceptable criteria and enable them to reassure the service users that they have enough information to mitigate the risks and ensure that the successful bid has enough contingency to undertake the service provision in reasonably foreseeable adverse condition (weather, loss of communications, premises etc.).”

29A.8             The Chair responded that “The CCG can confirm that it has provided the relevant information to bidders so as to enable them to develop complete bids. The procurement process has included opportunity for bidders to raise additional clarification questions should they need to. This procurement process has allowed nearly two months for bidders to develop and submit bids, which exceeds the recommended timeframe of 25 days.

After bids have been submitted they will be evaluated against a set of agreed criteria. This evaluation process will include an opportunity for bidders to present their proposal to a panel of people who have lived experience of mental health problems.

Prior to the commencement of the formal stages of the procurement the CCG undertook market engagement, seeking valued input from service providers in the re-commissioning of the service. This began in December 2015 with a Request for Information (RFI) document supplied to providers containing information about the service and inviting their feedback. This was followed by a market engagement event which took place on 26^th February, at which all the interested providers were in attendance. Both the RFI document and the engagement event provided the commissioner with useful and informative feedback when considering how to procure the services. It also gave providers a substantial amount of time to prepare for the procurement before it formally commenced.”

29A.9                   Katrina Miller asked the following question (on behalf of Valerie Mainstone, who was unable to attend):

“I understand that Virgincare are bidding for the Public Health Nursing (0-19) contract. I also understand that this information – who is bidding for the contract – isn’t in the public domain.  Why are the HWB/Public Health department members not doing as the government Public Accounts Committee urges and displaying “more transparency and not ‘commercial sensitivity” when it comes to the contracting out of services that affect the health and wellbeing of every child in Brighton and Hove?

It further concerns me that Brighton and Hove Council is even considering awarding a contract to a company such as Virgincare. They are documented tax avoiders, with their parent company being registered in the British Virgin Islands, they have documented failings in their provision of NHS services and documented instances of unacceptable labour relations including downgrading of (previously NHS) staff.  Can I have an assurance that Brighton and Hove council will not award such a vital contact – or indeed any contract – to such a company?”

29A.10           The Chair responded that: “We have a robust process in place to ensure that we procure services that best meet the needs of the local population within the available budget. By following the process we can be assured the decision making is open, fair and transparent. This accords with legal advice and minimises any potential risk of legal challenge to the Local Authority’s decision making process when the contract is awarded. The integrity of this process is essential throughout all stages.

The process included the Director of Public Health and the Public Health Programme Manager, Children & Young People (at the time) taking the procurement of the Healthy Child Programme to the cross-party Procurement Advisory Board.

Information on the bidders: it is important that confidentiality is preserved during the evaluation process from the receipt of tenders to the making of a contract award decision. The legal framework requires us NOT to identify bidders during the process.”

29A.11           Ms Miller posed a supplementary question, asking whether the council was being too risk averse and missing opportunities to be transparent and democratically accountable. The Chair responded by saying that he was concerned that council procurement should be as good as possible and had enquired about whether the fair tax mark and employee engagement could be embedded in procurement processes as part of scoring for social value criteria.

29B   Petitions

29B.1The was a petition from Mr Carl Walker, presented on his behalf by Ms Katrina Miller, who informed members that almost 2000 people have signed either the paper or e-petition to date.

e- petition

https://you.38degrees.org.uk/petitions/petition-to-stop-the-sell-off-and-decimation-of-children-s-health-services-in-brighton-1

PETITION TO STOP THE SELL-OFF AND DECIMATION OF CHILDREN’S HEALTH SERVICES IN BRIGHTON

Please sign and share this petition to demand Brighton and Hove Council’s Health and Wellbeing Board stop the sell-off and mass budget cuts to our children’s health services

Why is this important?

Community health services for children and young people include health visiting, school nursing and the Family Nurse Partnership (FNP) – a programme for teenage parents. These services are essential for our children’s wellbeing but they are now under the most severe threat.
Private companies like Virgin care are being awarded huge contracts across many different health services but, because they want to make a profit, they reduce their costs by cutting staff and lowering standards and quality of care.

If you
• don’t want a company like Virgincare making money from the health of Brightons’ children
• don’t want to see our children suffer as a result of a £1m cut to their services
• Want to see the service properly funded and run by the NHS

then please sign and share this petition as widely as possible.
And please make your feelings about the potential privatisation known to your MP, local councillors and the local press.

29B.2 The Chair responded that the Board has received reports and also previous public questions about this tender. The next Board meeting in November already has an item on the Public Health Nursing. We will be receiving a report on the overview of the process, summary of the preferred provider’s submission, feedback on scoring and confirmation of the preferred bidders details will be presented to the HWB for agreement to award the contract.

29B.3 Peter Wilkinson added that people might wish to note that quality was weighted above price in the scoring for the contract. This should place NHS providers in a good position to compete.