Future of Local Maternity Services

The Epsom and St Helier Trust has compared the two current sites and has come to the conclusion that if it moves services to St Helier it only loses 626 births (mainly to Kingston I suspect) out of the current combined total of 4,400 (2,600 St Helier, 1,800 Epsom) whilst if it moves services to Epsom it will lose 2,452 deliveries. The options it proposes are as follows:

Option 1 - Status Quo, but with development of early pregnancy assessment unit at Epsom

Option 2 - Maintain labour ward at Epsom without anaesthetic cover

Option 3 - Consolidate obstetric and neonatal services at St Helier with development of Midwifery Led Delivery Unit on both sites. Ultrasound scanning, antenatal and community midwifery services on both sites. Early Pregnancy Assessment Unit and Maternal Day Assessment Unit on both sites

Option 4 - As for option 3 but with elective caesarean sections also carried out at Epsom

Option 5 - Move all obstetric and neonatal in-patient services to St Helier. Ultrasound, antenatal, community midwifery, and Maternal Day Assessment Unit at Epsom

It is going to start consultation on Options 3 and 5, so Councillor Jayne McCoy had better start campaigning hard for 3 if she wants it. I suspect Option 5 will be adopted on cost grounds, unless there is a strong campaign. The problem for Jayne and the NCT is that people in Epsom may campaign for Option 1, so the Trust will divide and rule again and option 5 will be adopted.

Sticky times for Shopmobility

The plight of Shopmobility illustrates the problem that voluntary organisations face when they are built up on time limited funding such as the lottery.

Tory Councillors should be wary of immediately criticisng a "cruel Council" for not doing more when it already funds part of the service. It could be argued that now the lottery money has run out the Council should increase its funding due to the excellent work of the organisation, but this might have to be at the expense of the other services, so any changes that "mainstream" Shopmobility as a local Council discretionary service. should be done through the budget appraisal process rather than on its own. Other organisations in a similar situation might apply, so unless a fair process exists, how do we treat all voluntary organisations fairly?

More and more nowadays sustainable funding needs to be a key prerequisite for an appraisal process for pump-priming the start of a new project unless its aims are specifically time limited.

No doubt the Council will put a few more pounds in to the project in due course, but I suspect this will be on the basis of a revised SLA that seeks an ongoing comittment to efficiency savings such as shared back-office functions with other appropriate bodies.

Preparing for the Council Budget

The Council Budget process is about to start. Comments can be emailed to:

budget@sutton.gov.uk

A few things to note:

1. As usual the local papers will be be flannelled by the Council Press Office into writing up a "massive cuts" headline in December and will then report that "it wasn't quite so bad" in Febraury/March. How boring - maybe they can think up something counter-intuitive this year? Sutton Council's combined Education and other services budgets may cross the quarter of a billion mark for the first time. Perhaps there is a story in that as well as the predictable stuff?

2. Council Tax is likely to be a lower increase this year. With only Tories as the opposition as the Lib Dems are likely to be more cautious. Of course Tories might not be clever enough to notice that and still demand large cuts, when they are already setting the Council Tax agenda. They should continue to act as "guardians of public funds" and claim any below 4% increase a victory.

3. The Lib Dems will, if they have any sense, avoid cuts to:
a) Education - impossible to do under the finance rules and not worth winding up schools.
b) Heritage - too many elderly Tories from Cheam will turn up to Strategy so best avoided.

4. The Lib Dems may make further changes to the Play Services and thus may create some opposition.

5. It will be interesting to see if the budget assumes any cuts from the Day Services Review. Tory Councillors should ask about this issue when the scrutinise the budget.

6. I don't assume there will be a Tory budget, but they may surprise us. Just because Islington Lib Dem Steve Hitchens and his political assistant suggested one shouldn't do one, doesn't make it right. When have Tories ever listened to Lib Dem advice before!

I will of course be analysing Lib Dem proposals and costing Tory utterences, so it will be interesting to see if they keep Peter Geiringer quiet this year!

The Developing Local Heath Service

Despite the Epsom and St Helier Trust Board meeting deluding themselves after £26 million cuts that they will have the money to develop colocated services at the Royal Marsden (presumably their managers keeping repeating this mantra to some of their consultants to keep them happy) in the meantime other areas of health and social care are getting on with providing new services:

1. The Terms of Reference for the SW London Hospital Review is now PCT led (see earlier post).
2. Page 34 of the Sutton Council Strategy Committee agenda refers to the new intermediate care service at Carshalton War Memorial site.

3. Page 38 of the Strategy Committee agenda refers to a Local Care Hospital (see earlier posting).

Hopefully a cheaper option of rebuilding St Helier over a 10 year period will be adopted at some stage. This is a much more realistic approach at present and would secure stong local support.

Unfortunately, elements within the Trust will still want to achieve its 1992 Strategy. In the current financial climate they will not be able to follow the previous plan. Thus reading between the lines watch out for a longer -term approach that includes:

1. A possible merger between the Epsom and St Helier Trust and St Georges in the longer run.

2. The Royal Marsden leading on a new CCH on the Sutton site. This will be backed by St Georges who want to move the St Helier A&E away from themselves. The fact they are now on the review steering group shows their active interest in this strategy.

The disadvantages to Sutton are that the CCH will be rather small and will be much more aimed at very high level cases. The Royal Marsden being a regionally specialist Foundation will hardly see itself as the locally accountable Trust. Epsom and St Helier Trust, if it survives, will be more of a land mananager of a number of sites such as Epsom and St Helier with minor injury units, mental health and intermediate care on them.

Sutton's Health Scrutiny Committee should look at these aspects rather than assume that the old BHCH is going to be followed through.

A New Local Care Hospital for Sutton

Para 3.1 on Page 38 of the Strategy Committee agenda says the following:

The Council is especially engaged in the development of local care primary hospitals in the new BHCH model and is expected to support the PCT's application for a local care hospital later this year."

This is likely to be the Shotfield and Mint House sites and adjoining land in Wallington. This is a good idea and should be supported. There will be some planning issues over the piece of green land between the current buildings but I am sure an innovative solution will be thought up.

PCT Takeover Better Health Care Closer to Home!

At the Epsom and St Helier Trust Board meeting they will report on the draft terms of reference along the following lines:

"The terms of reference are still awaiting final approval by NHS London. The latest draft is in substance little different from earlier drafts but places greater emphasis on commissioner leadership and the need to take account of the broader strategic perspective within South West London and London as a whole."

"Commisisoner leadership" means the PCT. This is good news as the acute trusts mishandling of the entire BHCH process in their desperation to continue the strategy first proposed in 1992 to shift services from St Helier to the Sutton site. The fact that the Acting Chief Executive of the PCT is also going to chair the steering groups shows how things have shifted in terms of leadership.

In another post I will be reporting on the development of Local Care Hospitals in Sutton. The Acute Trust should focus on managing its current finances and now allow the PCT to commission a full local strategy for the future.

Marching for St Helier

I was pleased to hear that 2000-3000 were on the St Helier Hospital march on Saturday.

This quite possibly is the largest ever March in Sutton. Certainly bigger than the Orchard Hill March in the mid 1990's and the Home Care March in 2000.

I was unable to attend myself as I was at a London Labour Party Conference, which passed a London-wide motion on health issues to forward concerns to the the government.

I think the concerns expressed by the public on the march and at the conference will have an impact, when the results of the London-wide review are announced.

Clearly we need to keep the pressure up, but we should still be optimistic.

I will comment more on the implications of the march in future postings.

Joint Health Scrutiny - 30 November - Cancelled

I have just been told that the Joint Health Scrutiny Meeting on 30 November has been cancelled. Below are a number of good reasons why this is a good thing if that is the case:

1. There would be little to report as Better Health Care Closer to Home (BHCH) at an acute level has clearly been overtaken by events. The London wide review will determine acute service provision. I suspect effective campaigning will led to less change in London than people think.

2. The Acute Trust financial position is more urgent. Surrey County Health Scrutiny Committee has already voted for formal consultation to occur in view of the loss of a quarter of beds. Merton and Sutton Health Scrutiny Committees may well also choose to support this. Surrey have suggested a joint meeting, but since the Acute Trust happens to be a provider to both PCT's and it is their commissioning that determines most of the cuts, it is probably best this is discussed at individual PCT level.

3. All other aspects of BHCH are now dealt with through PCT commissioning and the operation of their Turnaround Plan, which is now driven by a PCT level BHCH agenda. Future community provision will also be determined by PCT bids and I believe they may have bid for funds for development of the Shotfield and adjoining land for a Local Care Centre.

As a result of the above, I would suggest it makes much more sense for Merton and Sutton Health Scrutiny Committees to come together from time to time to discuss overall PCT policy. Any meetings with Surrey will be about the commisioning intnetions of two separate PCTs that just happen to use the same provider of services. It makes much more sense to look at those commissioning policies separately.

Carshalton and Clockhouse Area - 6 December

Just a few points:


Item 5 - Police

The update from the 5 Panels looks good. This is how it should be.


Item 6 - 79-97 Ruskin Road

The housing here is mainly temporary accomondation awaiting demolition. I am pleased the Committee is having a pre-planning discussion on this site.


Item 11 - Middleton Circle Parking

There are issues here, which need to be resolved now the clinic is open.


Item 13 - Future of Play Facilities

This wasn't in the copy of the agenda I received. I will report further on this.


Item 14 - Robertsbridge Toilets

A useful history. I hope the Co-op build the replacement in the next few months.

Strategy Committee Preview - 5 December

Just seen this. A few initial comments:


Item 5 - Mid Year Performance

Some slight weaknesses in Environemental Services but broadly on track.


Item 6 - Supporting People Inspection

A good 2 Star report with promising prospects for improvement.


Item 7 - Local Area Agreement

Performance Incentives for all Partners to share seems sensible and will strengthen joint ownership of the Agreement


Item 8 - Stanley Park School

The consultation on sites options seems sensible. They are:

a) Stanley Park School Current Site - Rather Small
b) Stanley Road Allotments - again small
c) Orchard Hill - Probably the best site, but is a complex process

If there is no flexibility, I suspect the school will end up rebuilding on the current site.


Item 9 - Waste Treatment and Disposal Service

A broadly senbsible joint procurement between, Sutton, Merton, Kingston and Croydon. I hope they have a good range of companies apply, including social enterprises.


Item 10 - Smoking Policy

A slightly more flexible policy on former manual staff and staff outside the building.


Item 12b - Oaks Farm

After two attempts to turn it into a cemetary and a Lavender Farm (run jointly by Bioregional and Yardley) the Council seem to have at last realised their responsibilties under the Landlord and Tenant Act and I suspect the new policy is simply to flog the farm to the sitting tenant.


Item 15 - Sutton Arena Security Works

This is a big piece of expenditure and the Tories are right to de-delegate an item that should have come to Strategy. However the £478,000 mainly capital expenditure seems right in view of the levels of previous vandalism and even a fire on the site. The car parking issues come as a response to demand from the Northern Wards Forum and should also be supported.

Council Forward Plan - December to March

Just to keep you informed I am publishing the December to March Forward Plan of Strategy Committee and Council Business with the usual commentary. Many Councillors tell me they find this info useful. I'm surprised the Tory Opposition don't use the regular item at Scrutiny Co-ord to ask for pre-decision scrutiny debates on selected items. It's not as if the info is secret.

The Links on each item should take you to the relevant Council contact.

1. Performance Monitor - Half Year Update
Decision Due: 5th Dec 2006

2. Updating the Local Area Agreement
Decision Due: 5th Dec 2006

3. Supporting People Programme
Decision Due: 5th Dec 2006
This could be of interest over the future of key social services

4. Waste Treatment & Disposal Services - Preparatory Work for Procurement
Decision Due: 5th Dec 2006

5. Shared Recruitment Services
Decision Due: 5th Dec 2006

6. Building Schools for the Future Project - One School Pathfinder Scheme - Alternative Site Proposals
Decision Due: 5th Dec 2006
Is Orchard Hill about to be considered for the new Stanley Park? If so they need to also improve the local bus service frequency.

7. Draft Urban Design SPD
Decision Due: 5th Dec 2006

8. Draft Car Clubs SPD
Decision Due: 5th Dec 2006

9. Council Tax Base 2007/08
Decision Due: 11th Dec 2006

10. Gambling Policy
Decision Due: 11th Dec 2006
No doubt we will see an interesting comment from Geiringer/Shields/Pickles (delate as appropriate) when this is debated with "fear of a casino" making an entertaining story.....for about two weeks! Remind me did civilisation end with the new licensing laws?

11. General Fund Expenditure Levels
Decision Due: 19th Dec 2006

12. 'Shaping Tomorrow's Sutton': Draft Corporate Plan 2007/10
Decision Due: 19th Dec 2006
This will be an interesting document and I will know doubt set out my views as will the Lib Dems through the final document. Hopefully the Tory group will set out their views as well?

13. Corporate Performance Assessment 2006
Decision Due: 16th Jan 2007
Will we remain an Excellent Council. I would guess so.

14. Belsize Gardens Extra Care Sheltered Housing - Care and Support Arrangements
Decision Due: 16th Jan 2007
Let's hope they will have replaced the Orchard at the back of the site?

15. Policy for the Operation of the Re-use and Recycling Centre
Decision Due: 16th Jan 2007
This seems to be doing better now, but the steps are still a difficulty for some residents.

16. Private Sector Renewal - Council Loans
Decision Due: 16th Jan 2007

17. Whole Life Cycle and Sustainable Building Appraisal Pilot
Decision Due: 16th Jan 2007
Let's hope it will not be as expensive as BedZed was!

18. Single Equalities Forum
Decision Due: 16th Jan 2007
Has there been any consultaion on this yet? It is probably sensible in view of national changes.

19. HRA Review of Rents and Charges for 2007/08
Decision Due: 16th Jan 2007
An opportunity for the annual review of Sutton Housing Partnership

20. Positive Activities Behaviour Policies
Decision Due: 16th Jan 2007

21. Care Matters - Transforming the Lives of Children & Young People in Care
Decision Due: 16th Jan 2007

22. Future Organisation of Early Years and the Play Service
Decision Due: 16th Jan 2007
This is important for the role out of 14 Children's Centres across the borough as well as for what remains of the Play Service that managed to lead to Sutton Grammar School pupils to petition Strategy Committee last time!

23. Commercial Waste Charges 2007/08
Decision Due: 16th Jan 2007
Well worth keeping an eye on in view of the need to increase business recycling levels.

24. Book Procurement Contract
Decision Due: 16th Jan 2007

25. Revised Tree Policy (Street and Others)
Decision Due: 16th January 2007

26. Draft S106 SPD - Results of Consultation
Decision Due: 16th Jan 2007

27. Revenue Budget 2007/08 - Consultation Responses
Decision Due: 5th Feb 2007
It will be interesting to see if there is much lobbying by groups this year. Note to Lib Dems keep away from Heritage to save yourself time. Will the Tories set out any detailed views even if they don't publish a full alternative budget?

28. Review of Sutton West Site
Decision Due: 5th Feb 2007
This has taken longer than expected and will have an impact on a numnber of social services units.

29. Day Services for Older People - Future Model and Commissioning Options
Decision Due: 5th Feb 2007
It will be interesting to see the results of the consultation and the impact on specific Day centres. The slower approach to implementing change should be welcomed that a big bang approach.

30. Street Scene Strategy
Decision Due: 5th Feb 2007
The current weekly rounds probably need a review. Area Committees should be allowed to feed comments to Strategy Committee prior to any final decisions.

31. Leisure Facilities Strategy
Decision Due: 5th Feb 2007
Hopefully we can move on from contact issues and now look at investment in the Westcroft and Cheam baths sites.

32. Football Strategy and Swimming Strategy
Decision Due: 5th Feb 2007
Do I detect a proposal to look at ground sharing between Sutton United and Carshalton Athletic. I assume the leases would prevent this being anything but voluntary?

33. Library, Heritage & Registration Strategies
Decision Maker: Strategy Committee
Decision Due: 5th Feb 2007
Could we at last see free admission at the Heritage Centre. Having argued for this for 20 years, I would be very pleased to see this.

34. Accommodation Strategy
Decision Due: 5th Feb 2007
Hot-desking for staff perhaps?

35. Insurances Tender
Decision Due: 5th Feb 2007

36. Corporate Procurement Contract
Decision Due: 5th Feb 2007

37. Performance Monitor - Third Quarter
Decision Due: 5th Feb 2007

38. Budget 2007/08 and Associated Matters
Decision Due: 5th Mar 2007
No doubt a lively debate, but will we know what a Tory Council would be like?

39. Review of the Constitution - 2007
Decision Due: 5th Mar 2007
I predict a review of Scrutiny, more SCAGs and a look at Area working.

40. Members Allowances Scheme 2007
Decision Due: 5th Mar 2007
If the Lib Dems are bright they will offer up some of this Tories, including for Opposition Deputy Leader and let them vote to reduce the money and prevent Peter Geiringer from getting any more!

41. Annual Relationship Management Letter 2005/06
Decision Due: 12th Mar 2007

42. Employee Survey
Decision Due: 12th Mar 2007
The third one in the last decade. Should be interesting.

43. Community Strategy
Decision Due: 12th Mar 2007

44. Sutton Partnership - Governance Proposals
Decision Due: 12th Mar 2007
I predict a smaller key body with the Leader of the Council taking a higher profile role

45. Environmental Sustainability Annual Report
Decision Due: 12th Mar 2007

Henderson Hospital

I note the recent concern over the future of this excellent mental health facility in Belmont Ward.

The Henderson does a good job and has never been debated by Health Scrutiny Commitee. I hope the next meeting requests a report on its future from the mental health Trust.

Development Control - 30 November

Interesting to see that one of the objections to the installation of the 5000 litre diesel tank at Sutton Fire Station is that it might be a fire hazard!! If the fire service can't keep that site safe, what hope is there for the rest of us!!:-)

Joint Health Scrutiny on 30 November

I see there is a formal joint health scrutiny meeting on 30 January. I am not sure what purpose it will now have when Better Health Care Closer to Home has sensibly shifted from an acute led process to a PCT commisisoned one. As a result I can't see what the purpose there is for Surrey Councillors to head to Sutton to talk about issues that in our locality are more of a Merton and Sutton issue now. If we are to have a Joint Scrutiny body it really should be a Merton and Sutton one, with Surrey County Council scrutinising their PCT. The cross boundary Acute Trust is dropping out of the equation as it will not be leading on the evolving community services.

Nevertheless it will be interesting to see what all the NHS people have to say and I hope to analyse that in due course.

Monday's Council Meeting

More commentary on Monday's Extra-Ordinary Council Meeting.

In many ways the meeting was a useful training session for Councillors on Council procedure, rather than a debate on the short-term Leisure Contract, which this Blog has covered in some detail (see earlier posts).

Extra-ordinary Council meetings are no doubt great fun and the acoustics of Meeting Room 1 make it much more lively, but in many ways they indicate a failure of process in a number of ways:

1. The GLL takeover of SCL was really a done deal. The big issue is the letting of a much longer contract in 2 years. If the Tories are serious about the issue they will use the Performance Commitee for post-decision scrutiny so lessons are learned for the future. In addition they should use the Leisure SCAG for pre-decision scrutiny of the 2009 contract. If they don't now do this the Lib Dems will rightly be able to criticise them after this debate.

2. The Council meeting also illustrates the fact that without an all-party Strategy Committee Tories will feel excluded from the decision-making process. The Lib Dems should offer them a place instead of the Scrutiny Chairs and the Tories should accept, however I suspect they will now refuse. Whilst I think they were right to refuse the Scrutiny Chairs (especially after the Lib Dems excluded the opposition from them in the 2002-06 period), I think they would be wrong to refuse a place on Strategy even if they want more than one. If they were to sensibly accept, they would need to ensure they were clear as to their position on issues prior to them coming to Strategy. So far they have not yet demonstrated that level of clarity, thus we end up having extra-ordinary Council meetings as a mechanism of post Strategy decision scrutiny.

3. The current Scrutiny Structure is weak. An alternative would be for Scrutiny Co-ordinating Committee to be beefed up as the Principle Overview and Scrutiny Commitee (with the audit role farmed off to a separate Audit and Performance Scrutiny Committee) with the Tories offered the Chair of the Overview and Scrutiny Committee (which they should accept - Graham Whitham would make an excellent choice?) with some stronger taskgroups and existing and some new SCAGs replacing the other Performance Committees. I suspect this sort of structure may well be adopted by next Summer.

I currently assume that lessons will be learned from this process and we may not see another extra-ordinary Council meeting.

Council Meeting Report

I will report in more detail tomorrow about the meeting, but my initial comment is that it illustrates to me the reaons why it was wrong to abolish an all-party Strategy Committee, as we may instread see more extra-ordinary Council Meetings

Extra-Ordinary - But is it a good idea?

The Tories have called for a special Council Meeting on 25 November to debate the takeover of SCL by GLL . My previous posts go into some detail as to how this outcome was always likely to happen once we heard from GLL in late 2005 as to their relationship with SCL.

John Kennedy was not at the Strategy Committee that approved the change and it is clear from his remarks in the Sutton Guardian that he has not fully read the report on the transfer as he gave no explanation why the Committee's decsion was incorect. Indeed Strategy Committee even followed his advice to look after staff and chose not to make 11 staff redundant in the run up to Christmas and have now properly funded staff pensions - a traditional Tory issue.

As a result I can only presume that having instead read the Council Standing Orders he has convinced his Group Leadership (I suspect the Group as a whole have not discussed this) to call an extra-ordinary meeting which under the 1972 Local Government Act only requires 5 Councillors to make a request. This may sound exciting but is actually counter-productive as I will explain.

Before I give reasons why this might not be a good idea and the alternative ways to have this debate, I should point out that over 20 years I was on the Council the Labour Group never called for an extra-ordinary Council meeting and I knew the Standing Orders by heart! Our view was that it was like a nuclear weapon. You threatened to do it and extracted a few concession from officers, but you never needed to use it as you could always secure a debate anyway with a bit of negotiations.

The reason it will not be a good idea is that:

1. I predict Graham Tope will get up and point out that calling a special Council meeting usually costs £5,000-£10,000 in staff costs, thus the Tories will stand accused of wasting money, thus blunting any attack they do have.

2. The Tories could instead have requisitioned the item and agreed to withdraw all or part of the requisition in return for a debate on the subject at the December Council Meeting, thus not costing the Council an extra penny. Indeed only requisitioning item (ii) or (iii) of the recommendation would have achieved a debate and final endorsement of the decision in December. If the Lib Dems had refused this, then the Tories would have built on the moral highground they established on this issue from the way they debated it last time.

The Tories have made the error in thinking they are in power and their delaying a decision really counts, when the reality is they should remember they are in opposition and their real test is the 2010 elections and the public will not remember this event, so all they required was a debate at the next Council and a few lines in the local press.

As a result of this tactical blunder the Tories have lost part of the moral highground they gained from their previous debate and have instead delayed a delicate legal contract and caused more worry to SCL staff.

The St Helier Hospital March - 25 November - A Briefing

People may ask what will the march on 25 November achieve?

It is important for a number of reasons:

1. It is vital to express concern about the level of cuts. The more people who attend, the more likely we will force the Trust to be more careful with what they propose. It is vital that staff morale is not damaged by the cuts and a good turn out will strengthen the hand of Unison and other staff reps to get the best possible deal out of the current proposed changes - both financial and structural.

2. It is vital to express concern over the current London Review of A&E services. The more people who attend the more we strengthen St Helier's case. As days go by I am getting more optimistic that we can retain most services at St Helier, however it requires continual vigilence and campaigning to secure the situation. Nevertheless there is still uncertainty over the future of maternity services. At present it is likely the Trust will propose a single St Helier based 3,800-4000 birth a year unit to replace the 1800 birth Epsom and 2600 St Helier unit (see earlier posts on this), though there is still some danger services will migrate to Kingson or Mayday.

3. A strong turn out will emphasise the need for extra investment locally thus helping the PCT's chances of getting funding for the Local Care Hospital at the Shotfield site. The march will keep up the pressure to develop local PCT comissioned community services prior to any other changes to acute services rather than the acute led BHCH. The PCT Turnaround Plan very much reflects this fundamental change in priorities and many of its principles are a step in the right direction.

4. Combined with the emerging local political consensus for the Royal Marsden to expand on the Sutton General site as a National Specialsit Centre instead of a CCH on that site, we start to see a consensus develop for where the main services in Sutton should be sited.

Do not believe that the march will achieve nothing. The fact it happens will force small but important changes on how this area is viewed by the London SHA. As the campaign to stop the sale of SWELEOC showed, we can not only win over a proposed change, but we can actually make a service locally subequently valued by those in authority within the NHS locally.

If the Royal Marsden does expand on the Sutton Hospital site, the irony is we could actually see that health services in Sutton will have in effect increased over the next few years . The theory will then emerge from Epsom that BHCH was just a red herring developed to get Epsom politicians, health professionals and residents to accept the principle of a single principal hospital which then allowed the 2000 "Investing in Excellence" proposals (ie the full internal merger of the Trust with St Helier as the principal hospital) to be implemented. I did warn many times that this was the likely to be the impact on Epsom and argued continually for investment in a two-site solution, rather than just in one. It is sad that some people are having to learn the hard way about this.

Thus the March on Saturday 25 November is part of a wider campaign that defends current services, but could also actually help with Sutton ending up gaining a wider range of services over the medium to long-term. As a result we may well see a retention of most key A&E services at St Helier supported by longer term redevelopment - but only if Sutton residents are seen to shout out loud for it on 25 November!

Health Scrutiny Report Back

I have covered much of their agenda in earlier postings.

Health Scrutiny was right to demand more info on what is a 10% cut in budget. The PCT has provided more on its cuts and Councillors would expect more infor on a similar level of cut by the Council. If necessary they should refer the issue to the Secretary of State.

We hear a lot about NHS redundancies, but what we forget is the impact of these cuts on the local economy through its potential impact on employment agencies who provide temporary staff for the NHS. Whilst St Helier uses 7000 people this is spread across 4ooo full-time posts which shows how many part time posts there are.

Beyond "Better Healthcare Closer to Home"

Though it was not specifically referred to at Health Scrutiny last night, the reality of BHCH is that Patricia Hewitt's comments in Parliament on 11 October are pretty explicit as repeated below:

"unfortunately the financial position in south london, in that part of the NHS, is worse than those involved believed it to be when they came up with a plan for a new hospital. It is, I am afraid, no longer clear that the proposal for a new critical care hospital and nine new community hospitals is affordable in the way that the local NHS originally planned it." (Hansard 11 October)

I think the implication is clear BHCH is dead as proposed from 2004 to 2005 and being totally consisitant on this issue, am actually pleased about this as it was a thoroughly unrealistic and top down acute led process.

Instead we are seeing the following:

1. A revenue led process, rather than capital led (ie buildings) approach to shift services to the community. In the PCT this is a comprehensive set of reforms. We still have much less detail on the acute side and the 200 bed cut out of 840 beds (23.8% of beds) has not been justified and Unison and the Health Scrutiny Committee are right to expres their concerns and in the latter case deamnd more info on what might be a "substantial variation" in service (Sally Brearley - Beddington South Lib Dem candidate and PCT Patients Forum) deserves plaudits for raising this.

2. A probable community hospital at Wallington based round ther Shotfield site assuming the PCT bid is accepted.

3 The Royal Marsden probably taking over much of the Sutton site (see previous posting).

Whilst we need vigilance and the Unison organised march on 25 November is important for keeping up the pressure to maximise service retention, the irony of the new process is that Sutton borough may effectively end up as a net gainer of NHS services at the end of the process as I will cover in a future posting, but we need to keep campaigning to that end. A very different way forward to the top-down BHCH approach!

This is why those in Sutton who accepted the original BHCH proposals in 2005 were actually selling the borough short to what we could now achieve.

Royal Marsden Super Hospital

For those NHS bureaucrats upset about the loss of their beloved Sutton Hospital CCH, I have some good news.

I hear that the Royal Marsden may be selling its Kensington site and moving all services to Sutton. This will require a large amount of the exisiting Sutton Hospital site.

I am personally in favour of this as long as it remains a specialist cancer hospital - which I think it probably will due to the nature of the bequests it receives. My worry is that some will see it as a way to bring in a CCH to replace St Helier A&E by the backdoor as an extended Foundation Trust. Most of that debate will be a Sutton debate, which will make it much more difficult to play off differnt coomunities as we saw with BHCH.

I am also pleased to report that Peter Geiringer of Sutton Conservatives supports an expansion of the Royal Marsden and I do not detect any opposition from the Lib Dems either, though that may be beacuse they are keeping their options open for the "backdoor option" above.

A number of questions:

1. Will the "rattle your jewellry" set in Kensington and Chelsea be supportive of floigging off the central London site. This may delay the project for a number of years?

2. What will happen to other services on the Sutton Hospital site including mental health beds? I think it is vital to retain part of the Sutton site for mental health purposes.

I will keep you informed on developments.

Beveavement Service Bereft!

In the end I was very impressed with the way the Health Scrutiny Committee handled the issue of the end of Sutton Beareavement Service, which recently lost its contact with the PCT and closes in March 2007. It looks to me that the national dirver for the change is worki being done to tackle the high levels of incapacity benefit caused by depression by significantly increasing the spending on "talking therapies" like CBT. The expansion is in principle a good thing and part of a wider "happiness" agenda (see Richard Layard's eponymous book on the subject), however the Bereavement Services has become a victim of this change.

It would have been hard for Sutton Council to take an outraged moral high-ground on this issue, after all it was Sutton Council that ceased funding the Bereavement Service in 2000 and expected the PCT to totally pay for them after that date.

I was pleased to see that Paul Burstow MP acted as a facilitator for the debate on their future in September, after all he was a member of a Liberal Democrat Group the withdrew their funding in the first place in 2000, so I assume he was making up for his earlier error.

In the end the Health Scrutiny Committee eschewed hypocrisy on the issue and sensibly asked Ruth Dombey to broker a deal whereby at least some aspects of the service are likely to survice in the new service.

Personally if I had been in charge I would have argued a few months ago for a Council budget growth item to retain a separate service in Sutton, which would be in line with what I did when I opposed the original Coouncil cut to their budget in 2000.

Community Engagement Performance Committee - 16 November

It is a pity this committee has such a weak agenda for what is an important area of work.

I am assuming this Committee still survives as at some stage it will be revamped as a Community Safety and Community Development Committee. It might then have the powers to scrutinise the Police perhaps with some added reps from the Police Consultative Committee on it, with that body acting as a more strategic body with the majority of local policing issues picked up by Safer Neighbourhood Panels and Area Committees. This is the sort of debate we should be having locally now.

It is good to see the SCVS is represented on the Committee. I made such a suggestion two years ago and I was pleased to see the Council take it up.

Strategic Planning SCAG - 14 November

Just read the item on Section 106 agreements. Interesting to note that 50% of the £2 million section 106 expenditure on local improvement schemes will be spent in the Carshalton and Clockhouse Committee area with only 10% to be spent in the now Tory controlled Cheam and Worcester Park Area.

Before Tory Councillors complain over the unfair distribution, they should remember the schemes are dependent on development being allowed in an area.

In other words if you want a larger local budget for your Area Committee you need to allow more development!!

Development Control - 15 November

A few items:


Item 2 - Iceland/Fitstop - St Nicholas Road, Sutton

I know Tony Shields is not so keen, but I think young people drinking in the High Street may be more intimidated by the regulars of the Bingo Hall when they come out at night!:-)


Item 3 - Kimpton Park Way

Seems reasonable, but couldn't we have have had a more up to date may, showing the road layout.


Item 5 - Carshalton College

The ASD unit seems a good idea


Item 6 - Kelvin House, Hackbridge

This may still prove an overdevelopment of the site as the previous application was refused.

The 40% affordable percentage looks good but why so few 3 bedroom properties, when we know this is where the demand is?

The site overlooks a local school and knowing that local Tory Councillors were quite concerned about this sort of issue, it will be interesting to see how they vote on this application?

Greenwich Leisure at last!!

In 1998 when we were setting up Sutton Coommunity Leisure (SCL), I queried why we were not simply arranging a contract with Greenwich Leisure (GLL)as they were already very experienced. Eight years on and they are now one of the largest worker co-operatives in the country.

As a result of the decision today at Strategy Committee I am pleased to see Sutton Council have at last agreed to sign a contract with them.

I have been predicting the possibility of this for weeks, since SCL gave notice. SCL were close to GLL (see previous postings) and we have known this at least a year ago, when we all visited GLL facilities. This was an organisation that had the local PCT on site and were managing all 5 of the 5 main Olympic host authorities. It seemed to me then that the takeover of SCL by GLL was on the cards and I said at the time to Leslie Coman that we should speed this up rather than be led by events.

The proposed arrangement makes sense as for an extra £98,000 (which will in effect pay for an underfunded pension scheme), 11 SCL staff will not be made redundant in the run-up to Christmas as the other private sector provider proposed. I assume for the cost of an extra 0.0392% of the Council Budget that local Conservatives like John Kennedy will be happy that SCL staff have been treated well in the run up to Christmas as this was one of his key points at the last Council meeting!

I am pleased the Council have recognised the potential benefits of a GLL contract and have set up a 26 month contract with GLL. It is now up to GLL to prove themselves and their Olympic and health connections. In the meantime Councillors will no doubt want to use the scrutiny process to ensure they live up to their commitments.

Free Admission for the Borough Museum.

For 20 years I have been campaigning for free admission to a borough museum. Indeed I first tabled a writtern question on this specific subject before the borough Heritage Centre even opened, so I am glad Tony Brett-Young mentioned my interest at Strategy Committee today.

I do believe it is an embarrasment that we are the only Council in London that charges admission to our borough museum, so I hope announcements today at Strategy Committee mean we can move to free admission in the next year bearing in mind this change will only cost between £6,000-£9,000 out of a quarter billion budget and I am sure the larger Tory opposition might be interested in this positive policy as well.

As a result of:

1. The Museum Accreditation Status agreed at Stategy today.

2. The requirement for our highly regarded cultural rating that we improve in future and that museum attendance is an existing weakness (10,000 at charged for Heritage Centre compared to 20,000 at free Ecology Centre).

3, Sean Brennan' comments at Strategy today that imply this is being looked at.

I really do hope Sutton can end its status as the only borough that charges for museum admission. I look forward to congratulating the Council in due course if that is the case.

A Hung Council and a 4 year leader?

Just a thought, but under the Local Government White Paper proposals, what will happen if we have a hunbg Council and by law have to elect a Council Leader for say the 2010-14 period?

What arrangements will the White Paper allow, bearing in minde 20% of local Councils are usually hung?

Strategy Committee Report

A few points:


Items 3 and 4 - Finance

Congratulations to the Finance staff for winning Local Government Chronicle awards for innovation!


Item 7 - Waste Management

As reported the decision to keep options open was sensible, however the review of weekly and fortnightly collection so far ignores "smelly non-organic waste". I await Colin Hall comments on this. No doubt David Pickles is ready to look into this.


Item 8 - Older People's Day Care

The consultation will continue to February. Some Day Centres may see this as a threat to their future.

Lyn Gleeson had a go against the government about education for older people. Easy comments in the absense of any opposition Councillors! The reality is the government has had to choose priorities and has massively expanded services for the under 5s. I suspect we won't see Lyn Gleesonb thanking the government for that before she goes on about other services. I look forward to her future comments! In the meantime the Council could announce it is prioritising extra services in this area as part of its budget, but somehow I don't expect that to happen as it is obviously the Government's fault!:-)


Item 9 - Durand Close and Related Sites

Sean Brennan was right to pick up on Sydney Road. This has taken a long time and the area is now an area with increased anti-social behaviour, which residents have spoken to me about. Perhaps him and Graham Tope shouldn't have agreed to move out the previous residents so quickly?


Item 10 - Phoenix Centre Heating

Interesting to note para 2.1 that solar, wind, geothermal heating etc were ruled out as Colin Hall pointed out at the meeting. It just shows how expensive the initial shift to a low carbon economy will be if even a long-term pro-environment Council isn't taking the lead. No doubt Lyn Glesson will say it is all the Government's fault!


Item 11 - Museums Accreditation

I am more than happy to credit Graham Tope for his 20 years campaign to implement the 1986 Lib Dem Manifesto for Museum Accreditation (I will just check my copy just to see the commitment he refers to as I recall it was for a Borough Museum and in the run up to the 1990 he claimed this commitment had been achieved with the establishment of the Borough Heritage Centre). However I do just feel he could have given it a bit more priority in the 13 years he was Council Leader!

Throughout his entire time as local Lib Dem Leader we were the only Council in London of any political party that charged admission to our Heritage Centre.

I will write in more detail on this issue in due course.


Item 14 - Leisure Contract

Greenwich Leisure appointed. It took 8 years since I first suggested we move straight to this rather than set up SCL, but at last we have co9ntracted with them. I will report in more detail separately.

Environmental Services - 7 November

Should have covered this earlier but a few points:

Item 6 - Cultural Services

It should be noted that we need to do better on the number attending local museums to maintain our culture score and thus our overall Excellent rating. I will cover things in more detail in a separate posting following Strategy Committee.

Item 8 - Kimpton Way Recycling Centre

Things have improved since April, when the site opened and I was present for the first queues. With only 26-30% of waste recycled I am still sceptical tha the site is large enough for what we hope will be increased visits. In addition the steps do seem to be off-putting to some residents who ahev complained to me about them.

Item 9 - Commercial Waste

Clearly take up has been less expeced. On the other hand this is an area we muc expand take up. I think we need to continue and to publicise it better with public reference to good business performers on the Council website and in Sutton Scene magazine. May be the Sutton Guardian can also publicise good performers on their Green Pages section?

Email and Surgery Update

Just to record we are now in November and:

1. Wandle Valley Ward is the only ward without a surgery

2. The Wrythe is the only ward where ther public can't email their Ward Councillors.

I have recently drawn this to the attention of Graham Tope who used to criticise Toery Councillors for not being in touch with their electorate.

Nowadays its is on;y Lib Dems in this position.

Do they really want the local Labour Party to circulate a lealfet to local residents in the two wards or will this be sorted out by the new year?

I will keep you posted.

Health Scrutiny Committee - 9 November

Items of interest:

Item 5 - Acute Trust Cuts

The Government is claiming there are currently only 903 actual redundancies across the entire NHS. I suspect much of the other cuts will impact on temporary and Bank staff, which could led to pressure on existing staff. This may present a quandary for health unions who want to see permanent jobs protected whilst recognising that some of their members and many potential members prefer these short-term jobs for personal, work/life balance or short-term economic reasons.

Item 6 - The Bereavement Service

Most new Councillors will be unaware that this was a controversial issue a few years ago, when the Council ceased its grant to this service and expected the PCT to pay for it. I suspect the PCT may now want to see a return to joint funding?


Item 7 - PCT Turnaround Plan

As I have said in earlier postings, the financial postion seems to be forcing the PCT to develop a revenue-led BHCH programme (ie moving the staff to the right places in the clinical pathway) rather than the slower and more controversial capital-led one (ie choice of buildings). it will be interesting to see how things are developing, but I think all this will be much less controversial than previous proposals and in the longer term PCT led services at St Helier Hospital, will be joined by a Local Care Hospital at Shotfield and improved clinic facilities at Robin Hood Lane, with the new Middleton Circle Clinic already operating.


Item 8 - Better Healthcare Closer to Home - (BHCH)

Presumably we are awaiting the London SHA review, but I suspect the maternity consultation is likely to be the main change locally in the short-term as the 1800 birth a year Epsom unit is merged into the 2600 birth a year St Helier unit. I suspect any further moves of high level services to St Georges will be dependent on how Patient Choice flows play out in the next few years. In the mean time I suspect there will be small improvements to St Helier and a review of usage of the Epsom site. The Denbies vinyard owners £66 million bid to take over the Epsom site and develop a cardiac centre of excellence may be resisted by the Epsom and St Helier Trust who want it to provide an income stream for their Foundation Trust bid, though the Secretary of State may be willing to accept it either on its own or as part of a Foundation Trust if it is supported by Chris Grayling and Surrey County Council. However it is likely this may split the campaign in Epsom as the unions and some local campaigners will see this as just privatisation of the service.

Strategy Committee Preview - 7 November

Items of interest:


Item 3 - Revenue Spend

The continued underspend in social services is remarkable and testimony to the work put in by social services management over the last 2 years. The overspend in Environmental Services is predicatble in view of the difficulties over the future of SCL which will be resolved in the next few months. I suspect the overall budget for Leisure may have to be increased slightly for a new provider to have a chance to build up the service and work with the Council to invest in the 4 facilities.


Item 6 - 2006/07 Budget

Good to see the identified £2.2 million Gershon savings are on track for 2007/08 (para 2.3g). When later in the year we hear the usual spin over "budget crisis" from the Council, lets not forget the Council is able to find efficiency savinf equivalent to 1% of its entire budget!


Item 7 - Waste Management

I have already commented on some apects of this. The "keeping ones options open" option makes sense at this stage. In the meantime it would also make sense to ensure our planning policies identifies the Beddington Lane area as an expanded "green technologies" corridor so that we can attract new companies interested in the expanign green waste market.

Clearly the report implies a review of what will in future go in weekly and fortnightly collection. Learning the lessons of the past, this would be best to do through:
a) A public consultation through Sutton Scene magazine
b) Questions in the 2007 MORI poll
c) A full scrutiny by the Environmental Services Committee with recommendations made to Strategy Committee, rather than the process being the other way round and Executive led.


Item 8 - Day Services for Older People

I have already commented on aspects of this. The consultation on option 3 is reasonable at this stage, but people will want to see what this means for their actual Tier 2 Day Centre, before signing up to any principles as the implication of the report (para 5.5) is that some may be reduced in size or even close as about one third (60 out of 188) of Tier 2 places go as a result of more active elderly staying more independent. However it is clear that Tier 3 Day centre provsion is likely to remain at the same size with a bigger shift to specialist capacity. The new facility at Belsize Garden will be also available for any expansion here. This is likely to be sited at Gaynesford, Cloverdale, Oakleigh and Belsize Gardens. I can see that Ludlow Lodge and Cheam Priory will not be used for this service.

The development of a wider market of local services through direct payments to older people is a reasonable aspiration (the one for the physical disabled works well), but should be phased over a number of years so that we do not demoralise skilled staff and volunteers. In addition, instead of the Council closing centres itself it should allow more independence to existing centres and allow the emerging market to determine whether they expand, close or merge.


Item 9 - Durand Close

It is a bit unclear what the covenants on the Harcourt Avenue and Ruskin Road sites say, but presumablythe general fund of the Council will be compensating the Housing Revenue Account for loss of income.

The revisions to the Durand Master Plan regarding the community centre and the shop seem sensible. The expansion of house gardens also seems like a good idea.


Item 11 - Heritage Service - Museum Accreditation

This is good news and could lead to the Council using £9000 a year to pay for free admission of the Heritage Centre. I will cover this more in another article.

Blogging in Sutton

Good to see the Sutton Guardian today has reported on this and other local Blogs. I hope local residents read them all.

This Blog is not just a personal diary like some of the others. It aims to publish new stories as well analyse other stories in the news. As a result I believe it complements the work of local newspapers rather than competes with them.

In recent months it was the first to break the news on Political Assistants and the future of the Carshalton War Memorial Hospital as well as the involvement of Greenwich Leisure in the replacement contract to SCL.

As well as the work of Sutton Council it also covers the work of our local MP's, the future of our local Hospitals (which it covers in great depth) and the work of our local Police.

I also have an additional Blog for more detailed policy postings called:
http://policy4sutton.blogspot.com

Whilst I am former Labour Councillor, this Blog is not an official Labour Party site. With Sutton Council reduced to just two political parties, the Blog also seeks to create space for a wider range of views on the direction of the Borough through allowing people to comment on postings. I am also happy to enable others to post on my Blog as well and have printed letters from local campaigns. Not all Blogs seek to do this.

For other political Blogs in the borough go to:
Colin Hall: http://colinhallsblogspot.blogspot.com
Richard Bailey: http://readmyday.co.uk/RichardBailey
Tom Brake: http://blog.myspace.com/tombrake
Paul Scully: http://paulscully.blogspot.com

Fortnightly and Weekly Waste - The Debate Continues

At Strategy Committee on 7 November, the Council will be looking at its future waste procurement and is currently aiming to broadly keep its options open. I will report on the detail of this nearer to Streategy Committee.

However in order to determine it futre contract as well as aim to increase recycling, the Council is likely to reopen what waste is collected fortnightly and what is collected weekly.

In Sutton this is a touchy subject following the wheelie bin fiasco of 1998/02.

So far the Council the Council is clearly intending to keep food and other organic waste collected on a weekly basis and perhaps increase dry waste collected forthnightly.

Broadly this makes sense and should increase the borough recycling rate.

However it is possible that some non-organic waste may need collection and thus the Council propbaly needs to consider a "smell test" with anything deemed smelly after a forthnight collected!!:-)

I look forward to how the Council addresses this issue.

Day Services for Older People - Review

Following Strategy Committee on 7 November, there will be a consultation on the provision of Older People Day Services Review, which should be completed by February.

Option 3 - which is "maintain some exisitng services and tender for some new services" is likely to be adopted for the purposes of consultation.

The review is likely to look at services currently provided for older people at:

1. Assessed Day Care Services
Gaynesford, Ludlow Lodge and Oakleigh

2. Preventative Day Care Services
Granfers Hall (Euro-Asian), Sutton Lodge, Oaks Way, Cheam Priory.

The imp-lication seems to be that some services for change quite significantly. I willl write further on this issue prior to Strategy Committee.

Sean Brennan for ever - The Local Government White Paper

The proposals in the White Paper seem broadly sensible, though they do seem to take away much of what is left of the Lyons Review, due to report shortly.

The following points are relevant to Sutton:

1. I presume the Lib Dems will want to go for a Council Leader elected for 4 years. This Sean Brennan is likely to be voted by the Council up to 2010. He will then appoint a Cabinet. I assume this will be a formality rather than leading to a Leadership election within the Lib Dems? Perhaps we should also have a further debate on whether an elected Mayor of the borough is appropriate.

2. Overview and Scrutiny will be expanded to cover areas wider than health, such as Policing. I think Scrutiny staff should be appointed by a panel of backbench Councillors.

3. The Standards regime on interests will be relaxed to enable Councillors to not prejudice themselves on local issues. This is a democratic victory over the previous legalistic regime.

4. More powers for local Councillors to stand up for their local communities and bring issues for scrutiny. Sutton will probably cover this through its area Committees.

5. Community ownership of assets. Perhaps this could be applied to libraries, parks leisure and heritage centres?

6. The right to set up a Parish Council's. Area Committees and Neighbourhood Forums should debate this issue first rather than there being a borough corporate review. This would be much more in the spirit of localism.

7. Local Independence over Byelaws. Sutton has reviewed these, but we could now debate other ones.

8. Combined Community Safety Teams. Sutton is ahead of the game on this issue and may have more Councils visit to see how it operates.

9. Local Ward Councillor Devolved budgets. This shouls be a 2006/07 budget growth item with the money that the Tories don't want spent on Councillors allowances shiftewd to this so that each group of ward Councillors has a £10,000 budget - a total of just £180,000 out of a borough budget of quarter of a billion pounds.

10. Less targets, but clearer local performance information for the public.

11. Stronger Council Leadership in Local Strategic Partnerships with the Leader of the Council deciding who should lead the LSP.

All the above is very welcome. I hope the Council uses all the new powers. I will cover many of the issues in more detail on this blog and in the Policy4Sutton Blog in the coming months.

Faith Schools

The Government's decision not to press the issue of 25% pupils from outside the faith in faith schools is interesting for its impact on Sutton.

In Sutton, whilst our primary faith schools draw from within the borough, a large proportion of secondary faith schools come from outside the borough due to very large diocese boundaries.

If the 25% rule had come in I suspect it would not have contradicted the Greenwich judgment which is supported by both the government and the national Tory opposition. Thus we would have still seen a lot of outborough non-faith pupils replacing the faith ones.

Therefore it seems to me there would have been less of an impact on Sutton.

In the long-run, I see excellence clusters of schools and individual learning plans as more important for improving the lot of Sutton pupils, as they would do most to wither away the difference between the 16% of Sutton pupils in the super-selective local grammar schools (50% of whose pupils come from the Surrey County area) and the 84% of Sutton pupils in our local voluntary comprehensives.

Parking Policy - The Richmond Experiment

The Richmond Council proposals to charge extra parking charges for gas guzzling vehicles will be interesting to watch. No doubt Sutton Council will wait to see the impact before trying it out itself.

Green charges and taxation is clearly developing, however it is probably more effective to tax use of cars and use road tax to tax types of cars.

I hope other local authorities try out other green taxation schemes so all can be evaluated in the next year or so.