Agenda item - Public Involvement

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Agenda item

Public Involvement

To consider the following matters raised by members of the public:


(a)         Petitions – to receive any petitions presented to the full council or at the meeting itself;

(b)        Written Questions – to receive any questions submitted by the due date of 12 noon on the 20 November 2013 (copy attached).

(c)    Deputations – to receive any deputations submitted by the due date of 12 noon on the 20 November 2013.



(a) Petitions


28.1    The Chair noted that there were no petitions from members of the public.


(b) Written Questions


28.2    Mr Ken Kirk asked the following question on behalf of Mr Dave Baker:

“The response dated 7 Nov. 2013 to our deputation to the Health and Wellbeing Board on Sexual Health Provision in Brighton and Hove on 11 September 2013 is inadequate.  In one item we sought an undertaking that competitive tendering would only be undertaken if there was clear evidence that it would improve service for patients.  Your response only listed official and governmental guidance.  Those documents supported competitive tendering on policy grounds and were not evidence based. Our question remains: what empirical evidence exists that shows that competitive tendering provides an improved service for patients? There is a strong possibility, if not mounting evidence, that competitive tendering may endanger patients’ health and that you and the CCG will be responsible for it by taking non-empirically based decisions.”  

28.3         The Chair accepted the lack of empirical evidence and gave the  following response:

“Like any other public body, the city council is required to follow the law, and EU procurement law obliges public sector bodies, at the end of the current contract period, to go to commercial tender for contracts over a certain size.

Public sector bodies are given little discretion in these matters, so analysis of the empirical evidence on the pros and cons of competitive tendering with regard to any specific contract is of questionable value when there is no option open to the council other than to go to tender.

However, when we do tender for sexual health services, our primary aim will be to improve services for local people by identifying the provider which can deliver the best possible quality, value for money and social value. As part of this we will ensure that the services commissioned address the sexual health needs of the population as identified in the local Joint Strategic Needs Assessment.”

28.4         Mr Kirk replied that he could quote a speech given by the Chairman of Monitor which stated that there was no absolute obligation to go out to competitive tendering.  Mr Kirk said he would make this paper available. There was no need necessarily to involve the private sector. He believed that reconfiguration was a cover for privatisation.  Mr Kirk said he could give examples of privatised services that had fallen short of expectation.  He mentioned Serco in Cornwall as an example.  

28.5         The Chair replied that the Council would pursue a route that best met the needs of people in the City.  He thanked Mr Kirk for the questions raised on behalf of Mr Baker.


28.6    RESOLVED- That the written question be noted.


28.7    Mr Ken Kirk asked the following question:

The Brighton and Hove Health and Wellbeing Board has a duty to produce a Joint Strategic Needs Assessment for the city. If we project forward a number of years, based upon the evidence we have of B&H CCG’s implementation of the Health and Social Care Act, then B&H healthcare system will be fragmented into a large number of contracts, some with third sector organisations, some with private health companies like Virgin Healthcare or BUPA, and those health services that private companies don’t want, probably because there’s no profit to be made, left to the publicly run NHS health trusts. However, what will be lost will be the coordination and cooperation that we now have in our unified NHS, with patient health as its only objective. For example, you may be aware that there’s a likelihood that sexual health services will be offered to tender. Does hiving off sexual health services, with the staff currently employed in Sexual Health forced to become employees of a private company, fit will B&H H&WB’s Joint Strategic Needs Assessment? Is privatising Sexual Health services really an evidence-based approach to the strategic planning of Brighton and Hove’s health and wellbeing needs?

“The policy intention [for JSNAs]  is that local services which impact upon health and wellbeing will be based on evidence of local health and wellbeing needs and assets, including the views of the community; meaning that services and the way in which they are provided meet local needs.” Section 3.3 ‘What are Joint Health and Wellbeing Strategies?’ of Statutory Guidance on Joint Strategic Needs Assessments and Joint Health and Wellbeing Strategies.


28.8         The Chair gave the following response:


“The city council will be taking sexual health services out to tender in due course. However, we have not yet begun detailed planning around this procurement process, and speculating about the identity of the future provider of these services at this point would be unhelpful: it is important that the council is not seen to have pre-determined views in regard to the procurement of a contract. When we do tender for the contract we will ensure that the services commissioned address the sexual health needs of the population as identified in the local Joint Strategic Needs Assessment

In broader terms the question raises the fear that increased ‘private sector’ involvement in the provision of healthcare services will lead to a more fragmented provider landscape, with a negative impact upon planning and co-ordination across the local health economy. Whilst this is certainly a valid concern, it needs to be recognised that we have had a plurality of providers across health and care systems for a number of years and are well-used to co-ordinating the work of different providers from a variety of sectors.”


28.9    The Chair added that there was no intention to definitely privatise any service.  The Council were attempting to achieve the best result for the City.  The existing configuration did not always achieve that aim.  The greatest concern was to achieve quality and social value from contractors.


28.10    Mr Kirk stated that he considered that a service was being privatised that could remain within the NHS.  He considered that reconfiguration was a cover for privatisation.  He questioned whether it was really necessary to hive off the service to a private company.  Mr Kirk referred to the corporate power of large companies who knew they could cut staff costs.  Mr Kirk stressed that the Health & Wellbeing Board should ensure that any decisions were objective and evidenced based.


28.11    The Chair thanked Mr Kirk for his question and stated that the council would follow whatever evidence was available. 


28.12  RESOLVED- That the written question be noted.


(c) Deputations


28.13  The Chair noted that there were no deputations from members of the public.


Supporting documents:


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