NHS plans slammed as ‘opaque and semi-secretive’


Cllr John Cotton heavily criticised the lack of public accountability and transparency involved in drawing up the Sustainability and Transformation Plans which will shape how local NHS services are provided over the next five years.

Birmingham and Solihull have been designated as one of 44 place-based footprints across England where local NHS provider Trusts, Clinical Commissioning Groups and local authorities have been mandated to work in partnership to draw up detailed local plans to be submitted to NHS England in October.

Answering a question at yesterday’s Council meeting as Chairperson of the Health, Wellbeing and the Environment Overview and Scrutiny Committee he claimed the committee had been frustrated in its scrutiny role and had been denied critical detail on the local ST plan and that would allow the STP process to be held to account.

Cotton said that “When it comes to the matter of local health and social care then transparency and accountability is absolutely essential. People do have a right to know what is proposed, what might change in their services and how they can challenge and influence those decisions. It is clear this is not the case as the STP currently stands”

The detail of what is proposed beyond a few broad headlines about the need to join up services and co-ordinate health and social care has not been made available.

“I think you can make assumptions as to what is involved, you only have to look at the funding crisis in the NHS and the funding crisis in adult social care across the country to reach the conclusion that it will involve more than some minor tinkering in the system.”

“The lack of transparency is not down to local government, it is down to the opaque and semi-secretive process stipulated by the DoH and NHSE. Frankly if local councils like ourselves tried to take budget decisions using a process such as this we would be rightly condemned for it.”

“So as Chair of the Scrutiny Committee I want to ensure that we shine as much light on the process and get access to that detail. The STP will be our principle concern as we meet as a committee in the coming months. It is a huge issue for our Health and social care system and we can’t allow decisions to be taken without public accountability, without some challenge and without some debate.”

Although the Health and Social Care Scrutiny committee is a local authority body it has significant legal duties to scrutinise and challenge proposed changes in the local NHS. Paradoxically the Chief Executive of Birmingham City Council is the STP ‘system lead’ for the Birmingham and Solihull STP footprint.

The City Council is in a highly contradictory position being integral to the development of the local STP planning, in having current and future budget cuts predicated on the success of STP (£20m for 2016-17), as well as having democratic functions such as its scrutiny duties over the reconfiguration of the local NHS.

The massive real cuts to NHS spending under the last Coalition and present Conservative Government are the backdrop to the Sustainability and Transformation Plans where NHS funding has massively fallen behind the health requirements of the population. The South and Central CCG estimates that by 2021 the  Birmingham and Solihull STP footprint of the local NHS will be £0.5bn short of the funds to enable it to balance its books while maintaining the required level of care for patients.

Birmingham’s Labour Councillors need to be unequivocal in opposing the massive Tory cuts to the NHS to come.


Keep our NHS Public Birmingham is campaigning against the privatisation of the NHS and for full democratic accountability of the STP process. Please join us! we can be contacted by e-mail btuchcc@hotmail.com


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