Agenda item

(A period not exceeding 15 minutes for questions from members of the public.)

 

Mr Doug Wright addressed the Board on a range of issues including:-

 

·       Suggesting that, given the significant amount of work in the pipeline, the Board might wish to review the frequency of its meetings so that it met more often than at present;

 

·       In highlighting the representation by the CCG on the HWB, Mr Wright expressed the view that, conversely, there should be DMBC representation on the CCG’s Board;

 

·       Whether the Board could give consideration to moving the order of business on future agendas so that the agenda item in relation to public questions was the last item, as was the practice at CCG meetings.  Mr Wright felt that this would enable the public to comment on what had been said in any debates;

 

·       Concern was expressed that the HWB might be ‘swallowed up’ and become a sub-committee of a larger body, if NHS mergers were pursued in the future;

 

·       Mr Wright also expressed concern that there were still no answers as to how the projected funding shortfall identified in the STP would be met.

 

·       Mr Wright asked the Board to consider making an additional seat available on its membership to allow a campaign group to be represented, which would give NHS users and the general public a voice on the Board.

 

In response, the Chair thanked Mr Wright for addressing the Board and he stated that his points would be given serious consideration.

 

~~~~~~~~~~~~~~~~~

 

Mr Tim Brown read out the following statement to the Board:-

 

“Chair, thank you for allowing me to address the HWB and its distinguished members. This is a very nerve wracking moment. 

 

What I have to say may get uncomfortable. I intend to speak truth to power.

 

It is simply impossible to talk about the roles that racism and discrimination play in the health of Black and Minority Ethnic communities in Doncaster without taking a hard look inward—without asking Doncaster HWB members to think about the ways that they and Team Doncaster perpetuate racism and bias.

 

The past remains the present in Doncaster . Issues of racism have been documented prior to the Professor Gus John Report Tired of Fighting report ; and more recently by Former DMBC Chef Officers , including the highly respected Former Director of Adult Care. And yet , the substantive issues of racial inequality and injustice remains stagnant across what is called the wider determinants of health.

 

Buried Within the BME Health Needs Assessment is the HWB Members responses to the survey on ‘common issues’ or areas for attention for improving services for multi-ethnic populations. Only 40% of the HWB member organisation bothered to respond.

  

·    Respondents were asked about activities to address minority ethnic needs such as outreach, awareness raising, monitoring referrals by ethnicity and monitoring DNA rates by ethnicity.  The majority of respondents did not undertake this type of work. 

 

Chair, it is really disheartening that the majority of Doncaster HWB membership are clearly indifferent towards its moral and legal responsibilities towards race equality and Health Equity.

 

Health equity means social justice in health (i.e., no one is denied the possibility to be healthy for belonging to a group that has historically been economically/socially dis- advantaged). 

 

Interestingly , Dr Habib Naqvi when setting up the NHS EDS system put at its core one question "how do those who share protected characteristics compare to those who dont" ? 

 

The point is this and was referenced by Dr Crichton in his recent column that there is a plethora of research that identifies specific health disparities from cancer , stroke , Heart Disease , maternity, perinatal care, suicide rates, diabetes etc that are particularly pertinent to BME citizens . 

 

Chair , and with respect if this HWB was fit for purpose and compliant with its moral obligations then surely such substantive issues such as Cancer be reflected as a priority within the BME HNA and action plan. It cannot be too difficult to assess a methodology that scopes these specific health disparities in terms of evidence etc . This will lend itself to setting:

 

A) the priority and B) the target and C) proportionate resources etc.

 

I would argue how does a monoculture governance structure such as this Health and Wellbeing Board that has abused and ignored the needs of BME Communities for more than a decade suddenly give itself the moral authority to somehow act in the best interest of all BME citizens?

 

The situation is so bleak that those amongst us who have served the NHS and across the public sector with distinction over many years are humiliated in having to ask for our rights only to be fobbed off Year on Year by those with the power to perpetuate racism and racial inequality in Doncaster. 

 

The BME infrastructure was dismantled to ensure that BME citizens had no effective voice or influence around the Team Doncaster and strategic partnership arrangement. This then made it easier to neglect BME needs and ignore addressing racial inequality.

 

With little Or no BME collaboration , innovation and challenge . BME engagement is more of an afterthought and BME tick box exercise involving the use of survey monkey placed on websites sites that are unfamiliar to BME citizens.

 

Chair, I cannot adequately put into words the sense of racial injustice when responding to the superficial imposition of a partially developed BME Health Needs Assessment and Action Plan. 

 

The action plan is silent on the health and wellbeing needs of the BME community, including my father's generation. 

 

And whilst I accept that in all likelihood the BME HNA and Action Plan will be rubber stamped by Health and Wellbeing Board members of whom many are non compliant with the Public Sector Equality Duty, EDS2 and Workforce Race Equality Standards, we cannot ignore the fact that the biggest threat to health and wellbeing of BME citizens are preventable diseases. 

  

The root causes of many of these morbidities are inextricably linked to the social determinants of health and the conditions that shape a person’s opportunity to attain good health and adopt healthy behaviours. 

 

These social determinants include access to safe housing, good jobs with living wages, quality education, good health care, healthy food, and safe places to be physically active. They also include racism, discrimination, and bias. 

 

It is easy to see how the continuation of the acknowledged racism and blatant racist acts that also featured within Professor Gus John Tired of Fighting report (2002) have made it virtually impossible for BME citizens in Doncaster to achieve optimal health.

 

Today, I am calling upon Team Doncaster and the HWB to start the process of dismantling the deep rooted racism and blatant racist by allowing credible people to undertake a Health Equity Audit and establish as a matter of urgency whether the out of date HNA and action plans including the disclosure that HWB members are not delivering activities to address BME needs is having a negative or positive an impact on the mortality and morbidity rates of BME citizens in Doncaster.”

 

The Chair thanked Mr Brown for his statement and confirmed that his points had been noted and would be taken into account by the Board.

 

~~~~~~~~~~~~~~~~~~~

 

The following question was submitted by Andrew Goodall on behalf of Healthwatch Doncaster:-

 

“Healthwatch Doncaster would value an update on the Health Needs Assessment (HNA) for BME Communities specifically:

 

a)   Publication of and access to the Health Needs Assessment for local people, communities, Provider organisation and Commissioners of services in Doncaster

 

b)   Information aboutfeedback and engagement with local communities about the Health Needs Assessment for BME communities – how can people get involved and engaged?

 

c)   Practical next steps – what plans are in place to ensure that the outcomes of the Health Needs Assessment will influence service development and improvement in Doncaster?”

 

In reply, Dr Rupert Suckling explained that further information on the BME HNA would be provided later in the meeting under agenda item number 13 – Report from the HWB Steering Group.  He confirmed, however, that the updated HNA had been received by the Board at its meeting in March and had been subsequently published on the HWB website.  The HNA was also available via the Team Doncaster and Data Observatory websites.  Dr Suckling added that the needs assessment approach and outcomes had been presented at the Inclusion and Fairness Forum in April and that the Action Plan which had now been drawn up would be widely disseminated.  He highlighted that specific engagement for each action listed in the Action Plan had been identified.

 

In reply to a question, Dr Suckling indicated that he would be happy for Healthwatch Doncaster to share the HNA documentation on its website.