Agenda item

Mr P Carter, Leader of the County Council, was present for this item, and Ms C Davis, Policy and Strategic Relationships Policy Manager, was in attendance.

1.         Mr Carter introduced the report and explained that the pilot Kent Health Commission (KHC), launched in Dover in June, offers an opportunity to see what practical changes will flow from the Government’s health reforms.  He outlined the aims and key features of the KHC and highlighted the following points:-

• He gave an example of the Whitstable Medical Centre, which operates in a polyclinic model. This model demonstrates a better way to deliver preventative primary health care and make optimum use of budgets by minimising A&E attendances, for which GPs are charged. Examples such as a polyclinic scheme currently running in Merseyside have shown good outcomes.
• the KHC is in line with Adult Social Care transformation, in trying to reduce residential care admissions and get best value from available finance.  It should be possible shortly to calculate what future savings might come from KHC.
• the Dover pilot of KHC can be used to inspire GPs and Clinical Commissioning Groups in other areas.

2.         In debate, Members made the following comments:-

a)         relatively small changes, for example, extending GP surgeries’ opening hours, can make them more accessible to working parents and others who might otherwise struggle to attend;

b)         the changes described in the report are very welcome and have been desired for many years.  With the NHS Health Check programme (described in item D2 on this agenda), KHC will have a big impact on GPs, and they must be confident of having the resources to deliver them;

c)         being able to access treatments at a local GP’s surgery is good news, and makes such treatments accessible for those who would have trouble travelling to attend an appointment at a hospital.  However, this must not lead to the closure of hospitals in the county, leaving fewer centres which will require patients and their families to travel long distances to access them. Another implication is to the quality of care available, as GPs are not specialists.  A patient will want to be able to access the most specialist services available;

d)         it is important to establish correct and good links between services, so patients are not directed to and fro between centres to access the services they need.  The Choose and Book system no longer exists in all areas, and the TACTIC private company of GPs does not offer a patient any choice of which GP they see;

e)         concern was expressed that the KHC had been developed as far as a pilot launch without being reported to and considered by this Committee.  The report does not make clear who has overseen its development and what involvement KCC has had in it, and where and how decisions have been made; and

f)          concern was expressed that, although the individual proposals are very sensible, their cumulative effect may be damaging, for example, in narrowing the range of services available in hospitals.  If services are taken away from hospitals, they will lose the associated budget.  The realities of health funding mean that hospitals use the budget associated with a particularly lucrative area of work to subsidise other areas.

3.         Mr Carter responded by adding that, as Kent gets a lower allocation of government funding than other areas, he had been championing the issue of health funding allocations for some time.  KHC is a way of optimising the use of available resources.  Some 75% of health spending is in hospitals, and too many people spend too much time in hospital for things which could be dealt with in community health services. GPs are charged for the costs of these hospital stays.  KCC has a role to play in influencing change in the health service, re-shaping spend and improving patient care and outcomes.

4.         The Cabinet Member, Mr Gibbens, commented that the KHC, along with the Shadow Health and Wellbeing Board, relates to Roger Gough’s portfolio. Work is ongoing and a future report to this Committee will give more detail. He said he personally welcomed the development of the KHC and was aware that the Secretary of State also welcomed it.

5.         RESOLVED that the information set out in the report and given in response to comments and questions be noted, with thanks, and an update report be made to this Committee’s September meeting.