You may have heard of STPs (Sustainability and Transformation Plans) which aim to integrate health and social care in the Norfolk and Waveney region. When they have finished “planning” we will have an ACO (Accountable Care Organisation) which will hold all the money for the region, limited to a per head total. Cuts of £300m have to be found. The ACO will decide who gets treatment, if it is free or means tested and who will provide it.
You may not have heard of any of this. That is because it has never been brought before parliament and “planning” went on behind closed doors. It is well advanced but thanks to the work of Professor Allyson Pollock and others the plans has been stalled, for the moment. Because they are illegal.
So what is wrong with ACOs? Apart from the hellish complexity and cost of bringing together various health trusts, GP surgeries, and private care companies, none of which fit neatly into the Norfolk and Waveney footprint, and apart from the question of further cuts, there is the question of who will be in charge of the ACO? What is the unspoken destination on the road that STPs are taking the NHS.
ACOs will be corporate bodies given 15 year
contracts and total control over heath and social care. They will have no public accountability. On their boards will sit hospital managers alongside care home company directors. Charging for services will be part of the business. Just as important will be who will actually run the ACO?
In Greater Nottinghamshire, for example, a contract to set up the ACO went out to tender and the winner was….Capita. Yes, the good people of Nottinghamshire will have their NHS in the hands of dodgy outsourcing mega-company Capita. Still, Capita seems to have itself outsourced the job to multi-billion dollar US corporation, Centene.
The government is now trying to legitimise its plans through winning over local councils and NHS bodies and by holding “consultation meetings” with the public. Understandably many councillors will be baffled by the complexity of the plans and the soft sell which accompanies them. The CEOs of NHS Trusts are unlikely to rock the boat. But the public might.
The shadowy people behind Norfolk and Waveney’s STP have held a number of meetings including in Beccles on March 7th. Like the one in Lowestoft they have not been publicised, invitations being sent to selected partners. They are ticket-only and held during the day when many people cannot attend. The organisers have refused to allow discussion of basic questions about the STP plans or about underfunding.
. This is neither “public” nor “consultation”. If the STP organised meeting in Lowestoft follows the same lines Lowestoft Coalition against the Cuts will take no further part and urges others to withdraw from the meeting too.