Appendix Two to My Letter of 7th Feb

These are copies of my mails with Ann Filby regarding my conflict of interest over STPs:

Hi Ann.  (11/12/17)


I’m afraid I have to announce a conflict of interest on Tuesday. I have been wrestling with it since the last Council. STP behind closed doors is criticised and opposed by all my colleagues, including those in the Labour party and I cannot 1 remain a party to it. 



Hi Mike. I’m not sure what you are saying or what that means so can you advise please? The Trust is signed up to the STP with a number of organisations locally and Christine leading on acute to ensure we have influence – Andrew Palmer is also heavily involved as is his deputy. Our Board has considered this in detail at every stage and is absolutely focused on its statutory responsibilities to our patients.  We are one of 44 planning footprints in the UK – with something having to change otherwise the ‘do nothing’ option means a huge financial black hole and unsustainable services.


Thanks. See you tomorrow. (11/12/17)


Hi Ann.  (11/12/17)


Yes I’m well aware of the Trust’s commitment to SDP and the financial implications thereof. This is however, a major problem within the disabled community and the Labour Party and as a disability rights activist and a member of the Labour Party I cannot collude with it. It is also contrary to my values of patient and public involvement and Equal Lives’ commitment to co-production. And more pertinently, contrary to Nolan Principles and our own Trust values. Perhaps the quotes below will make it clearer (ACOs are a product of STPs).


“From the beginning, this process was rushed and carried out largely behind closed doors, by health and social care leaders trying to develop impossible plans for the future while struggling to keep the NHS from the brink of collapse.” (BMA)


Keep Our NHS Public is opposed to STPs. They are a way of breaking apart the NHS, not the regional improvement in integrated care they are proclaimed as.


In March 2017, Simon Stevens published his implementation plan for STPs to deliver changes equivalent to £22bn of cuts, Next Steps on the NHS Five Year Forward ViewHe introduced his assumed organisational form that the new sustainability and transformation partnerships would take – a coalescence of provider trusts and CCGs with any willing local authorities in area-based alliance organisations.

Stevens has named these ‘Accountable Care Systems’ (ACS). He predicted that these would evolve in a varied number of years but in all areas, into hardwired structures he unashamedly gives the USA-derived title of ‘Accountable Care Organisations’ (ACOs) the ‘ownership’ of which would be via a 10-15 year contract tendered out to an interested party or parties, explicitly including the private health and financial industry. Model contracts put forward the possibility of a Special Purpose Vehicle. SPVs are notorious in the case of financial wheeler-dealering of private finance initiative contracts (PFIs).” 


“The unacceptable secrecy in which these ACOs have been conceived and are being pushed forward is totally contrary to the NHS’s duty to be open, transparent and accountable in its decision-making. The manner in which the government is approaching ACOs, as with STPs before them, fails that test.


Labour want to foster a new phase of openness and engagement in the public’s relationship with the NHS. We’ll begin by forcing ministers to account for their Accountable Care plans in public – rather than behind closed doors.


Jonathan Ashworth, New Statesman, 10th Dec, 17.”



Thanks Mike. Maybe when you are feeling better we should have a chat about this as I am not sure where this leaves us.

Take care.

Ann  (12/12/17)

Hi Ann. (12/12/17)


That’s fine with me. When and where will be most convenient for you (give me at least three days).



Mike (19/12/17)

I am free on 4 or 5 January after 10am, if either day is good for you?




Thanks Mike for today’s useful discussion.  I confirmed the need for openness on the STP when there is something to engage/consult on – and that the private session with Governors is to enable full and frank views to be expressed by Governors and the Chair/Chief Executive/Executives on any strategic topic. STP-wide communications capacity has been enhanced and there are plans to release more information but this does need to be consistent across all STP partners – we also had the acute services review engagement sessions in early December on the three specific services where we specifically set out to engage with patients that know the service ahead of any changes being proposed.  So on this basis you said you would keep this under review and there would be no conflict of interest at this stage. If you could confirm my understanding please that would be great.


We also had a good discussion with the Estates team on disability issues and I will get back to you as soon as I have an update.


Thanks again for coming in.


Take care.

Ann (04/01/18)

Thank you Ann for arranging the very positive meeting with estates. It not at all what I’d expected and I, on behalf of disabled users, am delighted with the plans. How much of this can I share?


You say: “So on this basis you said you would keep this under review and there would be no conflict of interest at this stage.” and that is correct. I have to say though, I’ll be watching for any hint of privatisation…


Mike.  (04/01/18)

Glad you felt it was positive. You can share about the meeting but probably not worth giving too much detail until we know from David what is manageable and affordable. But the will is there to do the right thing by all our patients and visitors which is a positive message.


Ann (04/01/18)


And then further news of ACOs came through renewing the matter of further privatisation…

Mike Llywelyn Cox.


In all, the JPUH managers (and the governors?) appear to live in a different world to the rest of us!


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