Meeting documents

To consider a report by the Transformation Programme Lead for the Adult and Community Services Forward Together Programme.

The Committee considered a report that updated members on the discussions and resolutions relating to the decision by the Dorset Health Scrutiny Committee to refer the Clinical Commissioning Group's (CCG) proposals for changes to service provision to the Secretary of State for Health. 

The report was introduced by the Health Partnerships Officer who explained that, although the Joint Health Scrutiny Committee (JHSC) did not support a referral to the Secretary of State for Health, it had agreed that further scrutiny of the capacity and performance of the ambulance service was necessary.  This would be undertaken by another Joint Committee already established to look at the NHS 111 service and a meeting would be convened in due course.

Councillor Nick Ireland stated that there was a public perception that the Dorset Health Scrutiny Committee (DHSC) was not fulfilling its duties and that changes to the Clinical Services Review proposals had taken place as a result of campaigning rather than the direct involvement of the Committee.  He noted that the retention of maternity services at Dorset County Hospital were as a result of withdrawal from discussions by the Somerset CCG. He considered that the residents in Purbeck would be disadvantaged with worse travel times in 9 out of 10 cases. Furthermore, these timings did not take account of waiting times in the ambulance on arrival at Dorset County Hospital.  He proposed that there was a reversal of the decision made by the Committee on 20 December 2017 and that the proposals in the Clinical Services Review (CSR) were referred to the Secretary of the State for Health.

Responding to the proposal, the Chairman stated that evidence and justification would be required in order to make the referral and that there was no evidence to suggest that communication had broken down with the CCG.

Members debated the proposal with some of the view that there had been insufficient engagement with the CCG and a lack of evidence that the proposed changes would result in better health services for Dorset residents.  They also noted that the proposals outlined in the CSR had recently been accepted for a Judicial Review.  It was suggested that a working group could consider any further evidence and assess whether the criteria for a referral to the Secretary of State had been met.

Legal advice was sought on this point and the Solicitor confirmed the requirement to establish whether the threshold for a referral had been met in the first instance. 

Some members considered that a referral could be made based on criteria in relation to the adequacy of the consultation and the proposals not being in the interests of the health service in the area, however, they accepted the need to consider further whether the evidence met this threshold before proceeding with a referral.

The Health Partnerships Officer informed the Committee that there had been engagement with the CCG for a period of two years prior to the formal consultation period.  The Joint Health Scrutiny Committee (JHSC) had submitted its response to the formal consultation which had included the comments of the Dorset Health Scrutiny Committee (DHSC).  The response had raised concerns, but had not been wholly critical of the proposals at that time.

Members also heard that Healthwatch had published its concerns regarding the consultation process and considered that there was a lack of understanding by citizens of the area in relation to the changes that were being proposed. 

Following some debate, it was concluded that the Committee should examine the evidence and further legal advice was requested. The Solicitor advised that the decision made on 20 December 2017 had been based on advice provided at the meeting which suggested that the threshold had not been met.  If there was further evidence then a report would be needed at the next committee meeting to outline this evidence. It was confirmed that a referral to the Secretary of State was likely to be put on hold pending the outcome of the Judicial Review.

Members felt that, even if there were insufficient grounds for a referral on the basis of inadequate consultation with the Committee, there may be grounds on the basis of the proposals not being in the interest of the health service in the area. In light of the evidence coming forward and to meet the legal requirements, Councillor David Jones proposed that a working group of members, to include the Chairman of the Committee, was arranged.  This group would ask for submissions, including from the public, Defend Dorset NHS and Healthwatch, and submit a report to an extraordinary meeting of the Committee to which the CCG would be invited.

Members were informed of the potential time constraints in providing this information prior to the next committee meeting scheduled in June 2018 due to the time necessary for the group to gather the submissions and to produce a report. 

Resolved (unanimous)

That the Committee, in the light of the referral of the proposals to Judicial Review, the concerns raised by Councillors and members of the public, establishes a task and finish group of five members including the Chairman, to reconsider the evidence and any new evidence which might be submitted and to report to a special meeting on a date to be arranged.