Agenda item

8.1

It was formally moved by Councillor Sue Alston, and formally seconded by Councillor Andrew Sangar, that this Council:-

(a)      recognises that the Health and Care Bill seeks to remove barriers to integrating services to improve health outcomes and reduce health inequalities;

(b)      broadly supports the Bill’s focus on improving the health and wellbeing of the population and the duty of bodies to have regard to this in making decisions;

(c)      supports the emphasis of the Bill on the duty to engage with patients, carers and representatives;

(d)      supports the requirement for NHS Integrated Care Boards and local authorities to establish a Health and Care Partnership with responsibility for producing an integrated care strategy;

(e)      welcomes the Bill’s recognition of the key role of Health and Wellbeing Boards and the health and wellbeing strategies and Joint Strategic Needs Assessment they produce;

(f)       welcomes the flexibility afforded to each Integrated Care System in making its own arrangements for joining up services and setting local strategies for improving population health;

(g)      notes with dismay that despite the Conservative Party’s 2010 pre-election promise that there would be “no top-down reorganisation of the NHS”, successive Conservative-led governments have been enacting root-and-branch reorganisation of the NHS in England, starting with the 2012 Health and Social Care Act, and continuing with Sustainability and Transformation Partnerships (STPs) which paved the way to the creation of 42 regional Integrated Care Systems (ICSs);

(h)      believes that this decade of system change has placed health and care services, and those who are responsible for commissioning, delivering, and monitoring them at local level, under enormous sustained pressure;

(i)       is troubled that the Health and Care Bill gives the Secretary of State the power to call in NHS reconfiguration proposals, and believes that the role of local health overview and scrutiny committees in these matters should not be undermined;

(j)       believes with great concern that this proposal does nothing to assist social care whilst this Government has continually cut support for local councils and vulnerable people;

(k)      is concerned that local authority influence over local health and wellbeing could be side-lined if Integrated Care Boards are not correctly constituted;

(l)       is concerned that the Secretary of State will be empowered by the Health and Care Bill to deregulate unspecified NHS roles currently safeguarded by professional regulation, which in turn could threaten patient safety and staff development and training;

(m)     notes with alarm that the Health and Care Bill allows private companies to sit on ICS Boards and Partnerships, and that NHS England has accredited over 200 corporations and businesses – many US-owned – to help develop ICSs;

(n)      is concerned that allocation of ICS wide budgets, if not accompanied by strong place-based delegation, could result in commissioning decisions that are based more on detached area-wide targets than on localised need;

(o)      is concerned that when the South Yorkshire ICS takes on statutory powers, Clinical Commissioning Group staff across the footprint will become a single SY NHS workforce and that staff may find themselves redeployed between places across the county;

(p)      believes:-

(i)       proposals for ICS’s do not resolve the issues of chronic under-funding, shortage of services, inequality, high staff vacancies, workload, and stress in the NHS, and that there continues to be inherent risks of increase of private contracts, more down-skilling and outsourcing of NHS jobs, reduced services, and significant spending cuts;

(ii)       it is time to restore the NHS to a fully accountable, publicly run service, free to all at the point of use, and that full scale repeal of the 2012 Health & Social Care Act and new legislation for a universal, comprehensive and publicly provided NHS are required;

(iii)      that the Government should provide far greater funding for social care to local authorities to create a National Care Service; and

(iv)      that genuine integration, based on the wider determinants of health, involves more input from local authorities not less, and that place-based decision making that allows for joint commissioning of NHS and Council funds to support local care provision is vital;

(q)      calls for the legislation to include the following principles to be incorporated into the constitution of the South Yorkshire Integrated Care System:-

(i)       no private providers should hold positions on the Integrated Care Board;

(ii)       all ICS bodies should allow for the full participation of local authorities;

(iii)      all ICS decision-making bodies to be held in public, with published agenda and minutes, and open to public and local authority scrutiny;

(iv)      continuation of the role of individual and joint local authority scrutiny bodies, with the ability to call in decisions;

(v)      delegation to place-based commissioning, including for NHS funding to be deployed into Joint Commissioning arrangements with councils so as to support local care provision; and

(vi)      safeguards for all NHS staff that prevent forced or unreasonable re-deployment; and

(r)       accordingly, resolves to forward this motion to the Sheffield CCG and the incoming Chair and Chief Executive of the SY ICS.

8.2

Whereupon, it was moved by Councillor Steve Ayris, and seconded by Councillor Joe Otten, as an amendment, that the Motion now submitted be amended by:-

1.       the deletion of paragraph (a) and the addition of a new paragraph (a) as follows:-

(a)      recognises that the Health and Care Bill seeks to remove barriers to integrating services to improve health outcomes and reduce health inequalities, but believes it fails to do so by only paying lip service to social care;

2.       the deletion of paragraphs (g) and (h), the addition of new paragraphs (g) to (k) as follows, and the re-lettering of original paragraphs (i) to (r) as new paragraphs (l) to (u):-

(g)      notes with dismay that the Bill, as drafted, would result in this Government breaking its manifesto pledges not to raise national insurance tax and that no-one would have to sell their home to pay for care;

(h)      believes that the Health and Care Bill seeks to raise taxes on low and middle income families, with the prospect of them losing their homes to fund care costs and does nothing to increase social care quality or capacity;

(i)       furthermore, notes that the Health and Care Bill makes no mention of the millions of unpaid carers in the UK who are twice as likely to suffer from ill health as a result of caring;

(j)       condemns the power grab by the Secretary of State within the Bill that includes the power to abolish arm’s length bodies and to approve or reject ICS Chairs, rather than protecting the independence of the NHS;

(k)      welcomes the Healthier Communities & Adult Social Care Scrutiny & Policy Development Committee’s decision to establish a Scrutiny ICS Liaison Group to monitor the development of the South Yorkshire Integrated Care System to ensure local Sheffield-place scrutiny by elected Members is integrated within the SYICS Framework;

3.       the deletion of original paragraph (p)(iii) [new paragraph siii], the addition of new sub-paragraphs (iii) and (iv) as follows, and the re-lettering of original sub-paragraph (iv) as a new sub-paragraph (v):-

(iii)      that the Government should establish a cross-party NHS and Care Convention to find a fair and equitable long-term funding solution for the NHS and social care, so that everybody gets the high-quality healthcare they deserve;

(iv)      therefore that the Government should put on hold the Health and Care Bill until proper social care reforms are brought forward;

4.       the addition, in original paragraph (q) [new paragraph t] of a new sub-paragraph (i) as follows, and the re-lettering of the original sub-paragraphs (i) to (vi) as new sub-paragraphs (ii) to (vii):-

(i)       that the NHS must ensure that the health and wellbeing of unpaid carers are taken into account when decisions are taken concerning the health and care of the person for whom they care;

8.3

On being put to the vote, the amendment moved by Councillor Steve Ayris was carried.

8.4

The original Motion, as amended, was then put as a Substantive Motion in the following form and carried:-

RESOLVED: That this Council:-

(a)      recognises that the Health and Care Bill seeks to remove barriers to integrating services to improve health outcomes and reduce health inequalities, but believes it fails to do so by only paying lip service to social care;

(b)      broadly supports the Bill’s focus on improving the health and wellbeing of the population and the duty of bodies to have regard to this in making decisions;

(c)      supports the emphasis of the Bill on the duty to engage with patients, carers and representatives;

(d)      supports the requirement for NHS Integrated Care Boards and local authorities to establish a Health and Care Partnership with responsibility for producing an integrated care strategy;

(e)      welcomes the Bill’s recognition of the key role of Health and Wellbeing Boards and the health and wellbeing strategies and Joint Strategic Needs Assessment they produce;

(f)       welcomes the flexibility afforded to each Integrated Care System in making its own arrangements for joining up services and setting local strategies for improving population health;

(g)      notes with dismay that the Bill, as drafted, would result in this Government breaking its manifesto pledges not to raise national insurance tax and that no-one would have to sell their home to pay for care;

(h)      believes that the Health and Care Bill seeks to raise taxes on low and middle income families, with the prospect of them losing their homes to fund care costs and does nothing to increase social care quality or capacity;

(i)       furthermore, notes that the Health and Care Bill makes no mention of the millions of unpaid carers in the UK who are twice as likely to suffer from ill health as a result of caring;

(j)       condemns the power grab by the Secretary of State within the Bill that includes the power to abolish arm’s length bodies and to approve or reject ICS Chairs, rather than protecting the independence of the NHS;

(k)      welcomes the Healthier Communities & Adult Social Care Scrutiny & Policy Development Committee’s decision to establish a Scrutiny ICS Liaison Group to monitor the development of the South Yorkshire Integrated Care System to ensure local Sheffield-place scrutiny by elected Members is integrated within the SYICS Framework;

(l)       is troubled that the Health and Care Bill gives the Secretary of State the power to call in NHS reconfiguration proposals, and believes that the role of local health overview and scrutiny committees in these matters should not be undermined;

(m)     believes with great concern that this proposal does nothing to assist social care whilst this Government has continually cut support for local councils and vulnerable people;

(n)      is concerned that local authority influence over local health and wellbeing could be side-lined if Integrated Care Boards are not correctly constituted;

(o)      is concerned that the Secretary of State will be empowered by the Health and Care Bill to deregulate unspecified NHS roles currently safeguarded by professional regulation, which in turn could threaten patient safety and staff development and training;

(p)      notes with alarm that the Health and Care Bill allows private companies to sit on ICS Boards and Partnerships, and that NHS England has accredited over 200 corporations and businesses – many US-owned – to help develop ICSs;

(q)      is concerned that allocation of ICS wide budgets, if not accompanied by strong place-based delegation, could result in commissioning decisions that are based more on detached area-wide targets than on localised need;

(r)       is concerned that when the South Yorkshire ICS takes on statutory powers, Clinical Commissioning Group staff across the footprint will become a single SY NHS workforce and that staff may find themselves redeployed between places across the county;

(s)      believes:-

(i)       proposals for ICS’s do not resolve the issues of chronic under-funding, shortage of services, inequality, high staff vacancies, workload, and stress in the NHS, and that there continues to be inherent risks of increase of private contracts, more down-skilling and outsourcing of NHS jobs, reduced services, and significant spending cuts;

(ii)       it is time to restore the NHS to a fully accountable, publicly run service, free to all at the point of use, and that full scale repeal of the 2012 Health & Social Care Act and new legislation for a universal, comprehensive and publicly provided NHS are required;

(iii)      that the Government should establish a cross-party NHS and Care Convention to find a fair and equitable long-term funding solution for the NHS and social care, so that everybody gets the high-quality healthcare they deserve;

(iv)      therefore that the Government should put on hold the Health and Care Bill until proper social care reforms are brought forward; and

(v)      that genuine integration, based on the wider determinants of health, involves more input from local authorities not less, and that place-based decision making that allows for joint commissioning of NHS and Council funds to support local care provision is vital;

(t)       calls for the legislation to include the following principles to be incorporated into the constitution of the South Yorkshire Integrated Care System:-

(i)       that the NHS must ensure that the health and wellbeing of unpaid carers are taken into account when decisions are taken concerning the health and care of the person for whom they care;

(ii)       no private providers should hold positions on the Integrated Care Board;

(iii)      all ICS bodies should allow for the full participation of local authorities;

(iv)      all ICS decision-making bodies to be held in public, with published agenda and minutes, and open to public and local authority scrutiny;

(v)      continuation of the role of individual and joint local authority scrutiny bodies, with the ability to call in decisions;

(vi)      delegation to place-based commissioning, including for NHS funding to be deployed into Joint Commissioning arrangements with councils so as to support local care provision; and

(vii)     safeguards for all NHS staff that prevent forced or unreasonable re-deployment; and

(u)      accordingly, resolves to forward this motion to the Sheffield CCG and the incoming Chair and Chief Executive of the SY ICS.

8.5

(NOTE: In the absence of a mover for the amendment, Amendment Number 5 on the list of amendments circulated at the meeting, was not considered by the Council.)