Consultation on the Darzi Report

Dear Chairman


Consultation on the Darzi Report

- A democratic and voluntary sector protest, part 2


The strongest protest has to be repeated at your Board’s Nov 20th meeting, that was made at its Sept 18th meeting over the proposals of your Chief Executive on the consultation arrangements for Professor Darzi's “Healthcare for London - a Framework for Action” - reference my letters of Sept 17th and 19th.


1. Your Board dealt with only one aspect of the problem, as do the Minutes, and as did your Oct 10th letter - but failed to clarify the standpoint of NHS London on these consultations, and on its statutory duty to consult under the 2001 Act. Accordingly, I wrote to its Chair, Dr George Greener, also on Sept 19th.


1.1 Dr Greener was good enough to reply on Oct 11th, but to my incredulity and astonishment. He spelt out that “the consultation is the responsibility of the PCT, not NHS London” explicitly denying his SHA’s statutory duty.


1.2 Vincent Cable MP, at his surgery on Friday, confirmed his meeting with NHS London last week - as does his attached Nov 15th letter. He writes “You are correct. They (NHS London) do have to consult.”


2. It has taken 2 months for the NHS to clarify its standpoint, during which NHS London has done a complete volte face or turn around. No wonder Richmond’s public, its patients and its voluntary sector have been confused!


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Would the Board now confirm that it was equally confused, when it took its Sept 18th decision on these Darzi consultations, and that the Chief Executive’s proposals were based on misleading, if not false, guidelines from NHS London?


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Your Oct 10th writes of you “personally representing Richmond and Twickenham PCT on the Joint Committee of PCTs.” Would you advise your fellow PCT representatives of this derelict confusion of NHS London, and would you please propose that something of a united protest is made?


3. It should not have required the intervention of Twickenham’s MP to secure a proper acknowledgement of the SHA’s and our PCT’s respective statutory duties. If the PCT was at fault, then the Council and its Health Overview and Scrutiny Committee should have secured a correction. Should not both the PCT Board and the Council reconsider their decisions - as the latter will be asked to do at this Thursday’s Health OSC? Or is the Darzi consultation going to continue to “be the responsibility of the PCTs and not NHS London,” giving PCTs precedence over its SHA - a patent nonsense to any member of the public concerned with healthcare?


3. This protest has direct relevance to Attachment C on the “Ethical Framework for Priority Setting” and on Attachment E the draft “Richmond Compact.”


3.1 Clarity is of the first importance under the Compact. A clearer distinction should be drawn, e.g. under “National Standards”, 5 of the framework, between discretionary guidance and compulsory directives in their different forms whether under statute, or from the Health Secretary, or from the SHA.


3.2 Progress on the Ethical Framework will “continue on an annual basis”, in which case it is precipitate and premature to “sign off” the first framework before receiving the report of the Professional Executive Committee.


3.3 In many ways the current framework is excellent, but its statement on equity, para 5, has to be disputed. The public expects the NHS to show “positive discrimination” towards solders wounded in Iraq and Afghanistan - and indeed on other occasions, according to the consciences of the PCT’s decision takers. Decisions will never be wholly clinical as the third “response” implies, no matter what the law states.


4. Since this protest is also addressed to Councillors, the further request is made that the Council raises it with “London Councils”, the organisation that represents all London’s 32 boroughs.


I hope to be able to attend on Nov 20th.


Yours faithfully




Francis King


c.c. Councillor Nicki Urquhart, Chair, Health OSC.

Councillor Denise Carr, Cabinet Member, Adult Social Care

Councillors Serge Lourie, Council Leader and Nicholas True

Gillian Norton, Chief Executive; Jeff Jerome, Social Services Director

David Cornwell, CVS Chair; John Ray, VSCG Chair

Margaret Dangoor, PPIF Chair

Dr George Greener, Chairman, NHS London

Vincent Cable, MP; Susan Kramer MP