Agenda item

Questions from the public in accordance with Council Procedure Rule 13:-

Meeting of Council, Thursday, 21st September, 2017 6.00 pm (Item 37.)

(a) Question from Ms. Louise Harrison, 101 Elmfield Road, Hyde Park, Doncaster, DN1 2AZ, to the Mayor of Doncaster, Ros Jones:-

“South Yorkshire Women’s Aid is a vital service. Many of Doncaster Council’s own agencies refer clients to it. Nevertheless, DMBC has still stated that it has no money to fund the service after December. However, in DMBC’s statement of accounts 2016/17, it states that it has £97 million in ‘usable’ reserves, £20 million being ‘unallocated’. The Department of Education also awarded DMBC £3.1 million for DV services, of which SYWA received none. You also have a pot of around £1 million of grant under spends for the stronger families programme. Therefore, will DMBC use these monetary resources to fund SYWA?”

(b) Question from Mr. Steve Merriman, 10 Cedric Avenue, Conisbrough, Doncaster DN12 3PB, to the Mayor of Doncaster, Ros Jones:-

“NHS – Accountable Care Systems

John Major and particularly Tony Blair, used PFI to boost private sector profitability and saddle the public sector with unsustainable debt. Complicated contracts and narratives designed to allay public opinion were used to disguise profit extraction for the private sector.

STPs and Accountable Care Systems are being similarly engineered. It is not difficult to conclude, that the man leading their introduction, Simon Stevens, Head of NHS England, has one ambition - to hand over a newly packaged NHS to his former colleagues in the USA Health Insurance Industry.

By default, DMBC is colluding in this; why?”

(c) Question from Mr. Doug Wright, on behalf of ‘Keep Our NHS Public Doncaster and Bassetlaw’ 15 Chantry Close, Cantley, Doncaster, DN4 6RX, to the Mayor of Doncaster, Ros Jones:-

“South Yorkshire and Bassetlaw (SYB) Accountable Care System

The current plans for the South Yorkshire and Bassetlaw (SYB) Accountable Care System ensures that control of the Council's Better Care Fund is taken away from the Council and given to a myriad of unelected SYB Regional Officers/Committees.

We believe that paragraphs 6 and 7 of the current Memorandum of Understanding, shows how the SYB are illegally taking decisions away from the Council without their authorisation and consultation with the general public.

Following our consultations with the public, will the Mayor agree to oppose both the South Yorkshire and Bassetlaw (SYB) Accountable Care System and Memorandum of Understanding, and consider taking legal advice to protect the future health of our Doncaster people?”

Minutes:

(A) Question from Ms. Louise Harrison, 101 Elmfield Road, Hyde Park, Doncaster, DN1 2AZ, to the Mayor of Doncaster, Ros Jones.

The Mayor of Doncaster, Ros Jones, gave the following reply:-

“Thank you for your question Ms. Harrison.

Domestic Violence is wholly unacceptable and can have a devastating impact on victims and their children.

Since 2010, Doncaster Council has been forced to cut more than £200 million from its annual revenue budget and faces further significant funding cuts in the coming years. Notwithstanding this, the Council has prioritised tackling Domestic Violence as a key issue and spends in excess of £1m per year on related services, including:-

An Independent Domestic Violence Advocacy (IDVA) Service and coordination of Doncaster’s Multi Agency Risk Assessment Conference;

A Women's Refuge and dispersed homes with support services;

A Floating Support Service, helping people in their own homes; and

A Domestic Violence Helpline.

Following the decision by the Trustees of Doncaster Women’s Aid to close the organisation, local people wanted to set up a new successor charity. We supported that aim and provided a one-off grant of £30,000 and assistance from Council Officers.

However, as with all independent charities in Doncaster, South Yorkshire Women's Aid must plan to exist without reliance on funding from Doncaster Council, which unfortunately is simply not in a position to provide financial assistance to every VCS organisation facing financial pressures.

In terms of the specific funds that you have identified, the majority of the £97 million detailed in the Council’s 2016/17 statement of accounts, is already ring-fenced for specific purposes. This leaves £15 million general fund uncommitted reserves at the end of March 2017. We currently estimate that by the end of March 2018, this will have reduced to £10 million, which would support the Council for less than two weeks.

In March 2017, the Council identified a potential call on general uncommitted reserves of up to £9.5 million. These reserves are therefore not available to fund SYWA on an ongoing basis.

With regards to the Growing Futures Project, the Department for Education has not awarded the Council £3.1 million for current services. However, the Council has identified £3.1 million funding for the Doncaster Children’s Trust to maintain current programmes. This includes the previously Government funded Growing Futures project which focuses on support for children and young people. We also support the delivery of perpetrator programmes aimed at men who commit domestic violence, in order to reduce the number of repeat incidents.

Where delivered by external providers, services are commissioned through an open and transparent process in line with the Council's legal obligations.

At the end of March 2017, the Council held £1.2 million in earmarked reserves for the Stronger Families Programme, to provide an integrated approach to supporting families with additional needs. A significant element of the funding is performance based and as such, the level of funding is difficult to forecast. However, at current income levels, the earmarked reserve is forecast to be fully drawn down in the next financial year. Any reduction in these reserves will have a detrimental impact on the programme and thus impact on families in Doncaster.

I was disappointed to learn that at the present time, South Yorkshire Women’s Aid has submitted only a very limited number of funding bids, which even if successful, the trustees do not believe would be sufficient to keep the organisation running. Notwithstanding this, I would like to see South Yorkshire Women’s Aid continue its work.

The Council is therefore continuing to meet with the Trustees and I will work with them to sustain South Yorkshire Women’s Aid, if they are able to develop a credible plan for the future financial sustainability of the organisation.”

In accordance with Council Procedure Rule 13.10, Ms. Harrison asked the Mayor, the following supplementary question:-

“How many people here in this Chamber have visited the new Women’s Aid? Who is going to pay for the next funeral of a woman who dies or commits suicide? We are asking for no more than £30-60,000.”

In response, the Mayor gave the following reply:-

“I reiterate what I have said; we will meet with Women’s Aid in the next couple of weeks. If they provide a sustainable plan, we will work along with them.”

(B) Question from Mr. Steve Merriman, 10 Cedric Avenue, Conisbrough, Doncaster, DN12 3PB, to the Mayor of Doncaster, Ros Jones.

“NHS – Accountable Care Systems

By default, DMBC is colluding in this; why?”

The Mayor of Doncaster, Ros Jones, gave the following reply:-

“Thank you for your question Mr Merriman.

The role of Doncaster Council and its health and care partners is to secure the best health and wellbeing for Doncaster people from the public resources entrusted to us.

I cannot comment on the motivation or ambition of other individuals or your conclusion. I do not agree with your assertion that the Council is colluding in this.

However, what is clear to me is that there are always opportunities to improve health and care. Where these improvements could lead to better quality of care or patient experience of care, the Council and its partners would be foolish to ignore them.

As yet, the Council and Team Doncaster partners are unaware of any proposals for service change arising from the Accountable Care System. Any proposal for service change would be subject to our usual decision making processes and major NHS service change proposals are also considered by the Overview and Scrutiny process.

Finally, our over-riding concern is about the impact any proposal has on Doncaster people.”

In accordance with Council Procedure Rule 13.10, Mr. Merriman asked the Mayor, the following supplementary question:-

“The PFI was sold as the only game in Town. Now, STPs and ACS are being marketed in the same way. Do you believe that ACS will look to improve the health of your children and grandchildren?”

In response, the Mayor gave the following reply:-

“I will always seek to improve the health and care of the residents of Doncaster.”

(C) Question from Mr. Doug Wright, on behalf of ‘Keep Our NHS Public Doncaster and Bassetlaw’, 15 Chantry Close, Cantley, Doncaster, DN4 6RX, to the Mayor of Doncaster, Ros Jones.

“South Yorkshire and Bassetlaw (SYB) Accountable Care System

In response, the Mayor gave the following reply:-

“Thank you for your question Mr Wright.

The Better Care Fund is a programme spanning both the NHS and Local Government which seeks to join-up health and care services, so that people can manage their own health and wellbeing, and live independently in their communities for as long as possible. It is run by NHS England, the Department of Health and the Department for Communities and Local Government.

The South Yorkshire and Bassetlaw Accountable Care System has no control or input into the Doncaster Better Care Fund Plan, which was submitted to the national Better Care Fund team on the 11th September.

Sections 6 and 7 of the Memorandum of Understanding concern the direction of travel and key milestones’ and ‘governance, accountability and assurance’. The Memorandum is clear that Local Authorities and Clinical Commissioning Groups are not delegating any powers to the South Yorkshire and Bassetlaw Accountable Care System.

The Council notes the Memorandum of Understanding and there is support 'in principle' for the direction of travel.

We do have concerns in relation to the projected funding gap of £571 million within the plan over the next 5 years and the implications of this on the care, health and wellbeing of local people.

Our ambition is to improve health outcomes for all residents, reduce health inequalities and focus on ensuring the availability of services closer to home. These are the issues that resonate with our residents.

We are keen to see the importance of Place Plans reflected in the Accountable Care System. We know that only through collaborations, partnerships and adequate funding matched to need within and across communities, will there be a significant shift in the health outcomes for our population.

Therefore, Council’s efforts and focus must be located in working constructively with partners locally, to address the wider determinants of health.

We must ensure that prevention and early intervention remain at the forefront of activity, as well as improving pathways and services across a range of social and medical services for those that need it.

We welcome the opportunity to draw in additional funding to local places to aid the transformation in health outcomes we want to achieve for our residents.

We also welcome the opportunity to share learning across the different places within South Yorkshire and Bassetlaw, and will be working collaboratively to achieve this.

Given the importance of place, whilst supportive of the direction of travel and the ambition, each local area must be free to decide its position on proposals or service changes that have a bearing on their residents.

As such, Doncaster Council may in future, decide to take its own position on proposals or service changes that have a bearing on our citizens and place specifically, while remaining committed 'in principle', to the overall vision described in the Memorandum of Understanding.

The Council welcomes the opportunity to engage with the Accountable Care System to represent the needs and views of Doncaster. We would welcome further dialogue to recognise the unique role of Elected Councillors and their health & wellbeing responsibilities within the existing oversight and assurance arrangements.

A meeting to discuss this further would be beneficial at the earliest opportunity.”

In accordance with Council Procedure Rule 13.10, Mr. Wright asked the Mayor, the following supplementary question:-

“Thank you. I have a petition here disagreeing with what you are saying. In noting the Memorandum you are in effect agreeing it. This is not good, bad or indifferent. I came to the Council 9 months ago and asked the same question as to how this will affect 308,000 residents of Doncaster and still I have no answer. Will you hold an Extraordinary Meeting to discuss this issue which is going to be established as the new Shadow Health Body in April next year?”

In response, the Mayor gave the following reply:-

“I always want to ensure that the residents of Doncaster get the best possible care. I have no problem in referring your question to Overview and Scrutiny.”