Agenda item

(Report by Mr Paul Carter, Leader of the County Council)

(Mr Steve Phoenix, Chief Executive of the West Kent Primary Care Trust, Mr Glen Douglas, Interim Chief Executive Officer of the Maidstone and Tunbridge Wells Hospital Trust, Mr Greg Clark, MP,  Dr Bruce Pollington, Mr Derek Smyth and Mr Geoff Rowe were present for this item)

(1)     Mr Carter declared consideration of this item to be urgent so that Cabinet could consider the findings of the report published on 11 October 2007 by the Healthcare Commission into outbreaks of C.Difficile at hospitals managed by the Maidstone and Tunbridge Wells NHS Hospitals Trust.  It was also important to consider and agree how the County Council could at this time play a lead role in providing support and assistance to its NHS colleagues.

(2)     Mr Carter said whilst all were appalled by the findings of the Healthcare Commission, now was the time to see what needed to be done in order to take matters forward and restore public confidence.  Meetings had already taken place with representatives of the Trust and the County Council had offered a package of help and support.  This included making available, high quality managers from KCC to work with the Trust in a similar way the County Council had successfully supported Swindon Council.  The County Council had also offered to work with the Trust to strengthen the non-executive membership of its Board; establish a local Health Watch and provide other resources including, if, necessary, a loan of up to £5m over a three year cycle.  Mr Carter said this package reflected the leadership role of the County Council and its commitment to work with its health colleagues and other partners in order to restore public confidence.

(3)     Mr Phoenix said he welcomed the County Council’s support in looking to find a constructive way forward.  Those in the Trust would over the coming months, have to work hard to restore people’s confidence and this partnership approach was seen as being an important part of that process.  The Healthcare Commission report was a watershed and had to be used as an opportunity to move forward.  There had to be changes, and these had to include cultural changes.  Mr Douglas said he believed in partnership working and there had to be a focus on customer service, lessons in which the Trust could learn from KCC.  He  would be undertaking a management review and had already called in an expert to give an initial assessment as to the hygienic state of the 3 hospitals. The expert had reported that whilst there were things which still needed to be done improvements had been made and he had confidence in the hospitals.  Mr Douglas said also that in these circumstances, resources should never have been an issue and as part of the management review, there would be a focus on ensuring that there are the right people in top positions.  In addition an  action plan to address the issues raised in the Healthcare Commission report was being produced and this would be reviewed by the Commission itself.

(4)     Mr Greg Clark, MP said that the confidence of the people served by this Trust had been knocked and whilst it was good news to hear that levels of infections had been improved, there had to be a zero tolerance approach towards this issue.  Lessons still needed to be learnt and he said that the Trust needed to have a full time Chief Executive appointed as soon as possible.  Mr Clark also said that there was an issue of accountability which needed to be addressed and he also spoke in support of a new hospital being built at Pembury as soon as possible.  The PFI was in a critical period and everyone had to do all they could to ensure that the report by the Healthcare Commission did not affect that being taken forward.  Mr Clark concluded by saying that he would be meeting the Secretary of State in the near future and would be raising these matters with him.  Mr Phoenix said that the case for the new hospital at Pembury was a good one although the challenge was to demonstrate value for money and getting the balance of services right.  Mr Phoenix also said that the interim Chief Executive was working for the Trust full time.

(5)     Mr Gilroy spoke about the work the County Council was undertaking with the Trust and its interim Chief Executive in order to identify areas in which the County Council had knowledge and experience which would be of mutual benefit.  He said it was important at this time for services to work together in order to give the public reassurance and confidence.  Mr Ferrin said he was worried that some people would be so concerned that they may  postpone or cancell their treatment.  Therefore restoring confidence in the Trust was paramount.  Mr Douglas said he accepted that at the moment some people may not have the confidence to be treated at the three hospitals, but as had already been said, everyone was doing all they could and considerable improvements had already been made to make sure they were safe.  Mr Lynes said Members had a duty to the people who elected them and as such needed to see at first hand what was being done to address the issues raised by the Healthcare Commission.  Mr Gibbens said local people needed to be more involved and better informed about the work of their local Trust and Mr King spoke about of the importance of partnership working and the need to support the PFI for the new hospital at Pembury.  Dr Pollington said there was a very wide range of issues which went to make up the Healthcare agenda, and the way to provide greater public services was to take this work forward in the spirit of co-operation and partnership. 

(6)     Mr Smyth said shared the concerns which had been expressed but he had reservations about establishing a Health Watch. He believed the way to raise public confidence was through the Links Network for Health and Social Care which would becoming into operation from April 2008 under proposals set out in the Local Government and Public Involvement in Health Bill.  Mr Rowe said he felt it was important to move forward with what was available now.  There needed to be a flexible approach in how the issues raised in the Healthcare report were dealt with and therefore people needed to be given an opportunity to be involved in those issues as soon as possible.  He therefore saw no objection to the establishment of a Health Watch.

(7)     In concluding the discussion, Mr Carter thanked the Health representatives and Mr Clark for attending the meeting.  He said what was needed to help restore confidence was for the Healthcare Commission to give a commitment that it would visit the Trust again and undertake a further review to give endorsement to the actions the Trust was now taking.  Mr Carter said assurance was also needed from the Secretary of State regarding the PFI hospital at Pembury.  Mr Carter proposed and it was agreed, that for clarity some minor external changes be made to the recommendations set out in the report.

(8)     Cabinet:-

(i)       agreed the Leader and Chief Executive be authorised to negotiate with NHS colleagues a package of measures through which the County Council can help provide public reassurance on long term improvements; and

(ii)      approved the setting up as soon as possible of a local ‘Health Watch’ which provides the public an independent route for registering concerns about their local health services.