Agenda item

Any other business which the Chair considers urgent under the  Local Government Act 1972

The Chair raised the matter of the financial recovery plan prepared by the new North Yorkshire and York PCT.  He asked that this issue be considered under Urgent Business, on the basis that the plan was due to be put before the PCT Board for approval at their meeting on 9 January and, if approved, would become effective from 1 January.  These facts had emerged very recently, over the Christmas and New Year holiday, so this was the first and only opportunity that the Health Scrutiny Committee would have to consider and comment upon the plan before it was approved by the Board. 

The presentation referred to under Minute 37 above provided full details of the plan, which comprised the following proposed actions and initiatives to tackle the PCT’s projected year-end deficit of £45m:

• Measures to reduce expenditure on secondary care, including going no further than required in reducing waiting lists and achieving maximum value under the contract with York Cappio independent treatment centre by ensuring that all suitable patients be treated there;
• Reducing Accident and Emergency demand by more appropriate management of patients and introduction of more direct primary care involvement;
• Putting in place consultant-led clinical assessment teams for all acute trusts, to assess patients prior to admission;
• Proactive management of patients to reduce excess ‘bed days’;
• Establishing strong financial controls across the PCT;
• Reducing redundancy provision where possible;
• Minimising management structure costs.

The plan was intended to provide a balanced programme which would protect care services whilst providing options for managing the PCT’s finances. 

Members expressed concern about the short timescale set for the PCT Board to approve the proposals, the lack of prior consultation with the Health Scrutiny Committee, lack of provision for consultation with the general public (as oppose to special interest groups) and the failure of the PCT to liaise with the City of York Council’s Adult Social Services department regarding the potential impact of the plan on the Council’s services and budget.  In response, the PCT representatives stressed that the proposals to be put before the PCT Board on 9 January were intended as short-term actions for the final quarter of the current financial year and into next year.  A Service Modernisation and Financial Recovery Plan for the longer term would be produced and publicised within the next few months.  This would be subject to review and consultation as part of an ongoing process of development.  They agreed that it was essential to establish a dialogue in order to determine the effect of the proposals on Council-funded services.

Before reaching their decision on this item, Members considered and rejected the following alternative options:

Option 1 – do nothing.  This was not considered acceptable, as it would not discharge the Committee’s duty to represent York residents.

Option 2 – arrange another meeting to scrutinise the matter at a later date.  This was not considered a viable option, in view of the timescale for approval of the proposals by the PCT Board.

Option 3 – scrutinise the proposals over a period of time.  This option was rejected for the same reason as Option 2.

Option 4 – refer the matter to the Secretary of State in accordance with the Committee’s statutory powers under paragraph 4 of the Local Authority (Overview and Scrutiny Committees Health Scrutiny Functions) Regulations 2002, on the basis that there had been inadequate consultation with Health Scrutiny on the proposals.  This option was rejected as Members felt it would not provide a constructive way forward.

RESOLVED: (i)         That the proposals to be put before the PCT Board on 9 January 2007 be accepted, subject to the PCT undertaking to provide, during development of the financial recovery plan:

a)     adequate consultation arrangements with York NHS Hospital Trust and the City of York Council;

b)     a consultation process that includes the general public and voluntary organisations.

(ii) That all areas of the plan that may involve a change in service be subject to further review at the next meeting of the Committee.

REASON:      To ensure that the new PCT’s financial recovery plan is kept under review and subjected to proper consultation.