NHS CCG Merger Likely to Lead to Less Responsive, Less Transparent Decisions Over Local Healthcare Provision
A meeting of the governing bodies of the Bedfordshire, Luton and Milton Keynes NHS Clinical Commissioning Groups taking place tomorrow, Tuesday 22nd September, will decide whether to proceed with a merger to create one commissioning body for their combined area. Bedford Borough Liberal Democrats are calling for the merger plans to be scrapped due to the increased risk of a more remote healthcare commissioning authority covering a much wider area making decisions which do not meet the needs of local communities in Bedford Borough.
The merger would also be likely to mean less accountability and transparency over key decisions on local healthcare provision. In addition, Bedford Borough Liberal Democrats believe that such a major change in local health governance should be subject to a public consultation.
Bedford Borough Council's Executive agreed unanimously to oppose the merger, and you can read Bedford Borough Liberal Democrats' response to the plans, which were submitted to the CCGs earlier this month, in full below:
Bedford Borough Council Liberal Democrat Group is opposed to the proposal for the merger of the Bedfordshire, Luton and Milton Keynes (BLMK) CCGs.
Having considered the plans as set out in the One BLMK CCG Engagement Briefing and other public documents, we believe that this proposal will not benefit patients and will increase the risk of decision-making on healthcare services which is detached from, and unresponsive to the needs of the population in Bedford Borough. This will in turn create a greater risk of the provision of healthcare services which do not match the needs of communities across the borough.
A key reason given for introducing Clinical Commissioning Groups (CCGs) in place of Primary Care Trusts under the Health and Social Care Act 2012 was that GPs' local knowledge of the healthcare needs of their communities would lead to better care for patients, responsive to local needs. Indeed, the current webpage for CCGs on the NHS England website at the time of writing states that they result in care which is "designed with knowledge of local services and commissioned in response to their needs."
However, this merger will see one CCG serve a vastly bigger area and bigger population than the three CCGs do individually, and this will inevitably entail a dilution of the local knowledge and responsiveness of decision-makers.
Moving decision-making over local healthcare services further away from the communities affected increases the risk of decision-makers failing to recognise and understand the need for, and the value of particular local services. It will therefore increase the likelihood of harmful cuts or closures of existing services, and of failure to commission appropriate service in response to particular local needs.
In Bedford Borough, we have crucial ongoing issues over key local healthcare facilities. These include Putnoe Walk-In Centre, which is currently operated under a short-term contract, and which faces an uncertain future. A more remote CCG that covers such a vastly larger area as BLMK is less likely to recognise the local need for such highly-valued local services, putting them at greater risk.
We are also concerned that a more remote organisation covering a much wider area will be less open and transparent in its communication with local residents and their representatives. Previously a Liberal Democrat Bedford Borough Councillor and member of the Council's Executive was forced to use a formal Freedom of Information request to seek information which could and should have been provided to him by Bedfordshire CCG promptly and without reservation.
We believe that the proposed merger will only exacerbate this problem, with a more remote organisation covering a much larger area even less likely to operate in an open and accountable manner towards local residents and their elected representatives.
Finally, we would like to place on record our view that this proposal should be subject to a full public consultation. There has been an extremely limited effort at genuine engagement with patients and the public at large over this significant change in local healthcare governance.
Based on this limited effort there is no prospect that the joint governing body meeting on 22nd September can be provided with information that is representative of the views of patients and communities across Bedford Borough and the wider BLMK area who will be affected by the merger. In the absence of this, the joint meeting should not be making a decision on what would be a major change.
We thank you in anticipation of your consideration of this response to the proposal.
ENDS