Monday, 6 October 2014

The Cambridgeshire Amendment - Lib Dems win support for radical vision for health

Cllr Kilian Bourke
Cambridgeshire Liberal Democrats have won support for their vision for a more integrated NHS with a move away from the fragmented model that was introduced by the Conservatives in 1991, that has been deepened by every Government since.

The so-called “Cambridgeshire Amendment” was backed by every single Liberal Democrat local party in Cambridgeshire and Peterborough, because this area experienced so many damaging health projects under successive Labour Governments.

It would allow local groups of NHS providers and commissioners, where they desire to do so, to form a single integrated health organisations that would provide and manage care on an ongoing basis, instead of the current approach which is led by the commissioning of services.

It would allow local areas to abolish the purchase/provider split that has driven NHS reforms for the last 23 years, subject to local democratic support, and approval of the business case by Monitor and the Department of Health.

The proposal was overwhelmingly backed by delegates at the Lib Dem Autumn Conference this weekend allowing it to form part of the party’s pre-manifesto for the General Election.

Kilian Bourke, Chair of Cambridgeshire’s Health and Wellbeing Scrutiny Committee, who proposed the amendment, said: "Our local health economy has experienced enormous damage as a consequence of Labour's two disastrous PFI contracts in the north of the county, as well as the £1bn, 10-year, private sector contract to run Hinchingbrooke Hospital, which Andy Burnham put out to the market in 2009.

"Our proposal is at once radical and localist. We believe that the fragmented experience of care that many patients experience is at least partly caused by the fragmented organisation of the NHS, which is divided into purchasers and providers of services.”

He added that integrated contracts, such as the one recently awarded in Cambridgeshire for the older people’s services, can work but questions have to be asked as to whether it is the most efficient way.

He said: "This proposal would give local groups of NHS organisations the option to merge to form a single integrated health organisation that would manage the provision and integration of services on an ongoing basis, instead of the current commissioning-led approach.

"My view is that allowing an integrated NHS organisation to just 'get on with it' might well be more efficient and effective than the frequent competitive tendering of services. One of the great strengths of this proposal is that it would permit comparisons to be made between different models of providing NHS services, putting the current debate on the basis of evidence rather than ideology."

Spencer Hagard, Cambridge Lib Dem party chair, who summated the amendment, told the conference that this amendment “is sensitive to local knowledge, local conditions and local needs. It provides for learning from experience and is an evidence-based approach.”

Cllr Bourke said later: “I am delighted conference backed this amendment. It gives more power to people on the ground in a local area to tailor their health care to meet the specific needs of their area in an integrated cost-effective way rather than following a national one-size-fits-all approach.”