Health, housing and adult social services

Health, Housing and Adult Social Services Panel

Ealing TownhallLast night we met at Ealing Hospital. The substantial items on our agenda were:

  • changes to sheltered housing
  • Ealing Hospital’s foundation trust application
  • Ealing PCT’s finances
  • 2006 Adult Social Care star rating
  • Adult Social Care complaints.

We covered the social services issues in one block. Cllr Ian Green, Cabinet Member for Adult Services & Housing, talked us through the rationalisation of sheltered housing. The council is looking at taking out of service 4 schemes which are unpopular and under-utilised. Cllr Green reckoned that he would not want one of his relatives in one of these schemes. The panel welcomed the council’s sensitive and measured approach. The panel also welcomed the 2 star rating achieved by the council’s adult social services and congratulated the council’s staff on achieving this rapid 2 year turn-around. Mary Umrigar went over the latest complaints stats in adult social services. The evidence of systematic collection and analysis of this information and its use in driving service improvements must surely be one of the reasons why adult social services has been turned around.

Fiona Wise, Chief Exec of Ealing Hospital and her Chairman, Tony Caplin, talked about the hospital’s application to be a foundation trust. Ealing Hospital will be in the 6th wave. The timetable will probably involve a consultation in April with a view to becoming a foundation trust in 2008. They may try to recruit members before April. In trusts members elect governors who in turn elect the hospital’s chairman and non-execs. They are looking at recruiting 4,500-5,000 members, people like you and me. The hospital’s 1,619 staff will have to opt out if they don’t want to be members. Staff members will elect 5 staff governors. Some 3,000 local people will be able to elect 17 governors representing patients and public. It will be a big task to recruit these members and keep them engaged.

Finally, Robert Creighton, Ealing PCT’s Chief Exec, talked though the financial outlook for the PCT. In many ways the outlook is good. Next year will probably see the last big increase in revenue with an increase of 8.1%. After that increases are most likely to level. No doubt this will depend on the outcome of the Comprehensive Spending Review, but the PCT is using 3% per annum as a planning assumption. The financial stress in the NHS, especially in London, has had its impact though.

The PCT was top-sliced this year and will be next. In February 2006, just before the start of the financial year, a 3% top-slice was imposed. This means the PCT was forced to lend Patricia Hewitt £12.3 million to bail out poorly performing PCTs across London. As a result service improvements planned for this year had to be postponed. In November 2006 the PCT was informed that it would be expected to lend another 3.6% in 2007/8 or £16.4 million. These unsecured loans total £28.7 million that should be spent in Ealing this year and next but won’t be. The NHS bureaucracy has promised that this money will be repaid over the succeeding four years. In other words jam tomorrow.

I pressed Creighton to confirm that all we know is that we have had £28 million taken off us and we don’t know when we will get it back. He suggested that I might have an alternative career as a barrister but had to agree that this was the case.

If we really do get this money back over the four years (2008/9 to 20011/12) this may turn out to be a good thing. Much of the rise in NHS funding over the last few years has been badly spent because it has come at NHS bodies too quickly. These loans may have a useful smoothing effect that will ensure health resources are better used in Ealing – although the revenue rises will not be as large as expected they will trail off more slowly.

We live in hope. If we are to get this money back we have to hope that the badly managed PCTs in London can reform themselves to the extent that not only do they start living within their means but also they equip themselves to actually repay this money. It also assumes that the Comprehensive Spending Review doesn’t cause all the rules to be changed again. Ealing is relying on Patricia Hewitt’s good will to get is £28.7 million back. I am not sure I trust her. Do you?

Cllr Greenhead, the Labour councillor who had a go at me in the Ealing Times after my last report of this meeting, turned up as an alternate. She showed her deep concern for these issues by being 40 minutes late and leaving early. She made no contribution on any of the topics discussed.

Last night we had the Chairman and Chief Executive of Ealing Hospital, the Chief Executive and Director of Finance of Ealing PCT and the Cabinet Member for Adult Services & Housing. It is a shame that so few members of the public turn up to these sessions and miss out on the chance to meet these people and ask them questions.

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