Letter to Councillor Nicola Urquhart From Francis King

Dear Nicki

Localism, the PCt and the Council’s

Health Overview and Scrutiny Committee

While I am grateful for your letter of August 10th, nonetheless the strongest protest has to be registered. It counsels delay, when major health issues are being decided upon in the immediate future. It talks of debate, yet it represents the Council and the duty it owes to the Borough as a decisive voice in a much wider debate on health issues – along with other Council voices in our body politic.

I refuse to accept that the Agenda for your Sept. 19th meeting is set in such solid concrete that it cannot be amended. No doubt there are new Councillors on your Committee who will need training, but there is nothing like “jumping in at the deep end” to give that training a head start. Cohesiveness may be desirable, but more so is leadership and/or a firmer hand on the tiller.

Consensus may have its merits, but not if it is confined to seeking the lowest common denominator among the Councillors present. The Committee is not a convoy proceeding at the speed of the slowest Councillor, but one that is open to persuasion by the best informed Councillors, speaking either individually or on behalf of their political parties, currently two, of Richmond.

Your letter implies that Councillor Denise Carr, Cabinet Member for Social Services, will not be available for the September meeting. Either way, you as Committee Chairman can and should request a letter from her on the views and standpoint of the Cabinet on the following two issues. Further you can request the presence of Jeff Jerome, the Director of Adult Social Services, to clarify and expand on the Cabinet viewpoint.

1. “Commissioning for Health in London” announced at the PCT Board of July 11th, marks a major new initiative from within the NHS. It stems, however, not from Whitehall, but from PCTs and therefore has important “local” implications. It has the full support of Dr Vincent Cable MP, confirmed in his letter to me of Aug 5th to which you refer. Does it have the full support of your Committee to whom the Cabinet’s standpoint should be of interest?

2. Consultation on “The National Framework for Continuing Healthcare” comes to an end on Sept. 22nd. All your Committee members should have already read the consultation papers sent out on June 19th. One of them “Partial Public Sector Regulatory Impact Assessment” (which I received from the PCT only last Friday) sets out three options.

2.1 The third option reads – “Remove the boundary between health and social care so that funding for both health and social services is provided free at the point of delivery by the Body responsible” (a reprehensibly confused expression which the DoH later clarifies by distinguishing between “universal and free healthcare” and “means-tested social care”).

The Department of Health rules out this option and gives its reasons with which I happen to agree.

2.2 It would be a dereliction of your Committee’s duty (a) if it did not ascertain the Cabinet’s response to this consultation before Sept 19th and (b) if it did not provide the opportunity in its Agenda to debate and reach a conclusion, by vote if necessary, on this issue, hopefully helped by the Cabinet’s response. If that should be unavailable, it makes the debate all the more necessary, as would be a public rebuke of the Cabinet’s failure.

2.3 It has long been a plank in the Liberal Democrat platform, as I understand it, to “remove this boundary between health and social care”. Do the Lib Dems locally persist with this viewpoint, the difficulties with which Dr Cable touches in the second paragraph of his letter to me? And what is the standpoint of the Conservative Councillors on your Committee?

An urgent reply would be appreciated.

Yours sincerely






FRANCIS KING

Copies: Councillors Denise Carr, Serge Lourie and Nicholas True.

Gillian Norton, Chief Executive

Jeff Jerome, Director, Adult Social Services

David Cornwell, Chairman RCVS

John Ray, Chairman, Voluntary Sector Community Group

Dr Vincent Cable MP, Susan Kramer MP