Saturday 19 December 2015

Saturday, December 19, 2015 Posted by Jake No comments Labels: , , , , ,
Posted by Jake on Saturday, December 19, 2015 with No comments | Labels: , , , , ,

Between 29/10/2015 (9.30am) and 23/11/2015 (11.45pm) the UK Government ran a consultation that “Seeks views on the government’s proposals to set the new mandate to NHS England for this Parliament.”
The conclusions of the consultation were published on the 17th December, the day Parliament started its Christmas Holiday, presumably for avoidance of debate.

Complaints that this important public consultation was being carried out in secret were met by campaigns in particular via the 38 Degree organisation and by an article in the Guardian newspaper on 19th November, four days before the consultation closed. 

Even the Guardian seems to have been caught on the hop, its article stating:
"Jeremy Hunt has been uncharacteristically quiet about the invitation to all of us to comment on the proposed mandate. He made a written statement on the launch day but as far as I could tell, doesn’t seem to have said anything much about it since. I asked the Department of Health how many responses they’d had but they responded that they couldn’t possibly say. I asked NHS England what they think about the mandate and they said: “The mandate is a matter for the Department of Health and the public (via the consultation on it) – we wouldn’t have anything to say on it.” So far, so Kafka."

The result of this alert from 38 Degrees and the Guardian and others was a deluge of public responses. The government's response to the consultation stated that in the two previous consultations there had been a total of about 300 responses, while this time 127,400 responses were received. The government report stated:

“We have consulted publicly twice on the mandate in the past and on both occasions attracted around 300 responses, with slightly more than half originating from members of the public and the rest from institutions of the type described above. This year we attracted a similar number of responses from organisations. The public response, however, was significantly higher than in the past, with around 127,400 responses received by the close of the consultation.”

So what was the consultation about?
“The consultation contained five questions, with free text responses:
1. Do you agree with our aims for the mandate to NHS England?
2. Is there anything else we should be considering in producing the mandate to NHS England?
3. What views do you have on our overarching objective of improving outcomes and reducing health inequalities, including by using new measures of comparative quality for local CCG populations to complement the national outcomes measures in the NHS Outcomes Framework?
4. What views do you have on our priorities for the health and care system?
5. What views do you have on how we set objectives for NHS England to reflect its contribution to achieving our priorities?”


In its own response to the results of the consultation, the government admitted largely ignoring individuals who came as a result of campaigns such as 38 Degrees (they estimate 114,000 people), focussing on the 12,490 "unique" (i.e. not participating as a result of a campaign) contributions. 

However, even excluding these 'campaigners' the public response was overwhelmingly negative to government objectives:

The government report stated:
“The 12,490 'unique' responses not associated with any of the above campaigns consistently raised a number of closely related issues that cut across the consultation questions. The key issues related to funding, private sector involvement and staffing. These, along with our responses, are summarised below.

1. Opposition to further private sector involvement in the NHS;
2. Concern that there is insufficient funding to achieve the aims of the mandate and the NHS’s Five Year Forward View;
3. Concern that the mandate does not mention staff, concern over safe staffing levels and a desire to improve pay and conditions;
4. Concern over seven-day services. Qualitative analysis suggested fewer than 3% of responses that mentioned
seven-day services were supportive;
5. Concern over lack of integration, with concerns over funding for public health and social care;
6. Concern that there is insufficient funding to reduce inequalities, and that NHS England does not hold CCGs to account;
7. Very strong support for improving mental health services but concern that there is not enough funding to do so;
8. Strong support for focus on prevention of ill-health, but concerns that public health, community and social care funding is insufficient to achieve aims;
9.Shortness of the consultation period, and lack of publicity.”

This startlingly negative response even from the 'non campaigners' provides food for thought. The Conservative mandate from their 'stunning' electoral victory this year is a smokescreen. The Conservatives won a stunning victory in the 2015 general election. Stunning not because of its magnitude but because it happened at all. The victory left the Tories with the smallest majority in decades. 

And was due not to their own merit but to the success of the SNP in Scotland, and the punishment of the Liberal Democrats everywhere.

If the Tories don't get the message that with an effective campaign, such as conducted by 38 Degrees and the Guardian, the public will turn out to protest at their ideological obsession cutting the public sector, lets hope the opposition parties do. 

And lets hope Great British Voters will exercise their power and turn out to vote come election time.


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