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Wednesday, 30th August 2017

The Wool over our Eyes

The Wool over our Eyes.

Councillors must provide the right level of challenge to and scrutiny of the activities of the Council’s administration, and in order to do that they have to work hard to dig beneath the surface to find the true facts. That is much harder than might be imagined.

There are some examples also of how the Council itself is supposed to provide a scrutiny function of, say, Health Service provision, and especially of changes to services which adversely affect access to services for Surrey residents.

Members received recently a copy of the document which has been prepared for the Leader to brief the eleven Conservative MPs who represent Surrey, including of course the Chancellor and the Secretaries of State for Health and Transport. The document, which can be found here, https://orbispartnerships.sharepoint.com/sites/member_induction/Shared%20Documents/1b.%20MPs%27%20information%20pack.pdf sets out the context in which Surrey CC’s finances are having to function.

There are a number of graphs which set out visually the cuts Surrey has made and the cuts to its funding. Then there is this:

“Current Financial Position 2017/18 and Impact on 2018/19

After two months of the current financial year, services have already achieved over £30m savings with another £38m on track for delivery. Whilst this is good early progress, £7m of planned savings are now considered to be unachievable in addition to £9m of savings yet to be agreed.

In setting the 2017/18 budget, the council faced significant demand and cost pressures. The experience of the first two months of the year has seen numbers of children needing the support of Children’s Services increase is adding £9m pressure, while in Public Health, the retendering of a major contract is adding a further pressure of nearly £2m. The council is facing a £24m overspend this year (as reported to Cabinet 27 June) and appropriate management action is currently being assessed.

Members at Surrey decided at the very last moment not to proceed with a large council tax increase on 7 February 2017 on the understanding that MPs in Surrey had recognised the reality of our situation and had received assurances that help would be found during 2017/18. The basis of these expectations were conversations and letters with senior colleagues in Government. “

Actually of course, members decided not to proceed with a Referendum on the 15% increase! The paper also sets out the deficit in funding Highways, the cost pressures associated with the rise in Lone Child Asylum Seekers since the opening of the Cobham Services on the M25, and for services for people with Learning Disabilities- Surrey still has the largest proportion of people with learning disabilities in Europe.

I must say it is an interesting document to read but I have no idea either whether the comparisons are completely accurate, or how the document is likely to be read by the Ministers and MPs for whom it is written. There is the implication, I suppose, that along the way some unwise decisions were made by Surrey and the case for financial fairness was not properly made. But I have also to say that while many councils are looking at radical financial solutions to continue to deliver services within a shrinking budget, Surrey does not seem to be one of them.

County abolishes CEO position in bid to save £300,000”

No, not Surrey- this is a press report about Derbyshire County Council.   The Leader of the Council says. “we have a duty to Derbyshire residents to use their money as efficiently and effectively as possible,” he added. “There is no intention that the council will be making any ‘golden handshake’ payments. It’s about doing things differently and making bold changes.”

The news of the retirement of the Surrey CEO, David McNulty, has not produced such a response however. Instead there are advertisements appearing as follows:

Head of Strategy – Kingston upon Thames

SURREY COUNTY COUNCIL

£55,485 – £66,644 per annum.

We are seeking a highly political astute experienced senior leader with credibility and resilience to build alliances for the role of Head of Strategy. This is a time of significant change, nationally and in Surrey, and the next few years will bring huge challenges and opportunities for transformation and innovation. Surrey County Council is also appointing a new Chief Executive who will undoubtedly need strong strategic support.

This appeared in GuardianJobs on 25th August.

I don’t want to appear churlish, but either we haven’t had any strategy so far, meaning neither leading members nor officers are deemed capable of being strategic, or the previous strategy was all wrong. Either way, my reading of the paper for the MPs is that the 15% increase the council pulled back from in February is very much back on the cards, especially as there are not County elections next May. Yet there is not even a sniff of something which Tandridge District Council and many other local authorities have had in place for years- a recruitment freeze. There have been numerous staff re-structurings, which seriously damage morale and drive staff into a defensive position to protect their jobs, but the advertisement above seems to me to indicate something seriously amiss.

One of the tactics (or can it be called a strategy?) for filling the gap in finances which a number of councils have used (including TDC) is to invest in the commercial property market by using cheap loans from the Public Works Loan Board (at 2%).

However, just as this programme is getting under way, the press on 29th August carries the following report:

“Ministers are expected to call time on a spending spree by councils using cheap borrowed cash to stake multibillion-pound bets on commercial property.

The scale of local authority investment in shop premises, business parks and offices — often hundreds of miles from the council area — was revealed by The Times last month.

Local authorities spent almost £2.8 billion on land and buildings last year, more than double the figure for the previous year, as they chased high returns to pay for services. Now officials in the Treasury and the Department for Communities and Local Government (DCLG) are reviewing local authorities’ portfolios over concerns that the spending boom has got out of hand.”

You have to say the government is really making life hard for Local Authorities, even if Surrey is making life hard for itself.

Isn’t it time the government came clean and explain what the long term plan for local government funding is, so the public can express their view?

Health Scrutiny

The County Council’s Health Scrutiny function is a vital way of bringing some form of public accountability to those decision-making bodies such as Clinical Commissioning Groups which make the key decisions about our health. The Adults and Health Select Committee which meets on 4th September will receive reports on the re-commissioning of the County’s sexual health services (I can’t find a downside for East Surrey in this) and also on the work of the East Surrey and Sussex Sustainable Transformation Plan, STP. The STP is the vehicle for delivering cuts in the local health budget to manage the cash flat NHS. The difficulty for us at the County Council or in the community is that everybody knows there will have to be cuts, but everyone is terrified of saying where. This morning, 30th August, a leaked document to the GP journal, Pulse, makes plain that NHS England wants all GP referrals to Consultants to be reviewed by a Panel of other doctors with a view to cutting the referrals allowed by 30%. This of course seriously undermines the authority and judgement of your GP, but it isn’t about closing services, it’s about rationing.

Other forms of rationing are set out in general terms in the report of the East Surrey and Sussex STP:

“There are 8 CCGs in the STP–and there are at least 5 main versions of each clinical policy (this means that Patients referred to the same hospital for the same treatment are subject to different threshold policies).

The different policies mean that patients get different access and outcomes. If a common, revised policy can be established there will be:

-Greater equality of access to treatments across the whole STP footprint

-It will be cheaper for CCGs to maintain currency of common policies

All policies are being reviewed and detailed assessment of evidence supporting the policy and the degree of difference between each policy is being assessed.

Latest information on what the 8 CCGs spend with local acute hospitals indicates that there is substantial variation in numbers of treatments per 100k population– which indicates that there is non-clinical variation which could be addressed to release resources.

In other locations, improved policies and increased effort on end-to-end processes and compliance has stopped 5-15% of the activity, which could release £3-6m in a full year after implementation of the total programme.”

In other words, if all referral policies were made to conform with the ones which referred the fewest patients, savings of between £3 and £6 million per year could be delivered.

So if it is too difficult to talk about closing services, we will have to manage aggressive rationing.

While the County Council can comment, it is difficult to see how they can influence in a concrete way. And anyway, those savings are a fraction of what is required to balance the NHS system.

In July, the government announced an extra £325m in capital funding for a few STPs which are seen as being high-performing. Unfortunately, our STP has got a Grade Four (the worst), so none for us then! Poor East Surrey. We have such wonderful doctors and nurses but always seem to be scrabbling for funding. Something seems to be wrong.

Caterham Town Centre

I was pleased when Tandridge District Council commissioned consultants to produce, in consultation with residents, the Caterham Master Plan. While perhaps a mostly symbolic process, it does set out for potential investors opportunities for developing the Town Centre. While Caterham on the Hill is mentioned, plans for us up here are much more vague. The impetus for investment does rely very heavily on increasing residential yields. It is commercial investment we really need, but only after we have fixed the infrastructure.

So I was disappointed that the Council decided to withdraw from the Compulsory Purchase Process, which I first called for some years ago, on the old Rose and Young site. There was sufficient confidence that one of the developers would agree a scheme with the owner so the council pulled out to save legal fees and avoid possible delays.

I was disappointed because I felt that if TDC could hold the key site at the centre of the town it could influence in a more direct way the nearby sites which are so important, like Quadrant House, the key access road and the Waitrose site. I was disappointed that this happened in August, so there was no possibility of a proper debate.

Generally, August has been a rubbish month. Maybe September will be better.