Re-procurement of Community health services in Cornwall, 2015

21st September


We learned at the end of August that Kernow Clinical Commissioning Group has started an “open market procurement”, seeking expressions of interest from any company or organisation interested in taking over the services currently provided by Peninsula Community Health, in six months’ time.  These services include the running of all our community hospitals, all community and district nursing and specialist services, speech and language therapy, stroke rehabilitation, podiatry, Minor Injury Units, etc etc – in fact, a huge part of the work of the NHS in this county.

By December, when the decision must be taken, we will learn whether these services are to remain within our NHS ‘family’ or whether they will be run for the next two years by a private company / multi-national organisation.  Is this what the people of Cornwall want?

Our view, based on many years of experience in representing the public in West Cornwall, is that there is no public appetite for privatisation.  The public values its NHS, and wants to see it remain intact, rather than be fragmented and run for profit by companies who will be looking through their contracts for loopholes rather than focussing on the needs of their patients.  It is vital that people speak up now, to challenge the view of the
Clinical Commissioning Group that they would be ‘in breach of competition law and procurement regulations and would leave them open to challenge’ if they do not follow this route.

It is our belief that such tendering, apparently needed to avoid legal problems, will in fact prompt such legal difficulties.  The perilously short timescale will inevitably lead to gaps in the specifications, and such errors are likely to have disastrous consequences.   

Monitor, the Department of Health’s ‘sector regulator for health services in England’, which exists to ‘make the health sector work better for patients’, has been quoted as advising on such procurement. Yet they have clearly stated that ‘we do not have a view as to whether the clinical commissioning group should run a tender’.  This leaves us confused and mistrustful of the whole process.

Furthermore, it has been abundantly clear that our county’s previous forays into the murky world of “contracting out” have caused only trouble and a poorer service.  We have merely to utter the words “SERCO” or “MITIE” for everyone to understand what we mean!  To risk yet another such catastrophe would be the height of folly.

It is almost unbelievable that in the same season that ‘Devo-Cornwall’, and the drive to integrate health and social care provision, is on everyone’s lips, Kernow CCG is even considering further fragmentation with the possibility of a private company taking on such critically important health services. 

When Peninsula Community Health was established four years ago, we spoke out against the setting up of a community interest company, knowing of the significantly increased costs which would be incurred (in such areas as corporation tax, VAT etc); money which could otherwise have been spent on patient care.  Peninsula Community Health, although offered a contract extension, decided in June, after an independent audit, that they
were unable to continue to provide the same level of service, with increasing demand, on the money offered. Now the commissioners are offering a contract on this same money. How can a new provider deliver the same level of service and - if private - make a profit? They can’t – the service would be re-modelled i.e. cut!

By contrast, the only way the system will be able to work is if it becomes fully integrated, and the obvious solution will be to combine the work of RCHT with PCH (as was the case before the raft of reorganisations in recent years!) We know that RCHT has had some difficulties in recent years, but with the right leaders at the helm, an integrated service would eliminate the compartmentalisation, overlapping and duplication of services and provide a seamless service to the benefit of everyone in Cornwall.

Indeed, Kernow Clinical Commissioning Group acknowledge the desirability and necessity of this in their ‘Prior Information Notice” for interested parties, wanting to ‘reshape delivery, redesigning services in line with the Cornwall Devolution Deal, in line with integrating health and social care.’

We urge the CCG to start by integrating the acute and community health sectors within an NHS provider, keeping service provision within our community and serving the best interests of its patients; with all monies to be spent on patient care, rather than generating profit for a private company. To do anything else will end in tears.