Can we affect what happens to our NHS through the new Clinical Commissioning Groups?


Just Say ‘NO PP’

Some CCGs made it their policy to commission health services from the NHS, rather than private firms because of its value for patient care. So the government is tightening its hold over CCGs, and trying to force them to commission more and more services from the private sector – in the pretence of ‘patient choice’. If you only want to ‘choose’ the NHS if you need health care or treatment, give your GP a copy of the postcard below.


What are CCGs? Can we use them to defend the NHS?

Over the last two years, new health bodies have been taking over from PCTs, although they don’t become legal entities until 1st April 2013. The government claims that GPs, as expert health practitioners and knowing their patients, will be able to control millions of pounds of taxpayers’ money on health care spending through Clinical Commissioning Groups (CCGs). There are three CCGs in Manchester.

Retired Member, Pia Feig, has attended several CCG Board meetings to check what they are doing. Here are her impressions.

Financial Control: Central government has established CCGs as the agents/managers of their policies – to cut public spending and reduce the public sector, including the NHS. They have financial control of CCGs’ plans for health services—not just through very restricted budgetary allocation but through detailed tailoring of finance between different health services, the government’s designation of specialised service budgets, on capital and current spending, on wage rates etc.

Centralised Objectives: CCGs have to achieve many government objectives for their local health services, and then are allowed to choose two or three local priorities on top. They only get the money to implement local priorities if they succeed (a form of payment by results).

No Democratic Control: There is scant democratic control of the £million budget. There are no elected positions on the CCG boards. Some CCGs, like Trafford, have local councillors on the CCG board (although I’m not sure how answerable those councillors are to their constituents) but they don’t have to.

Limited Patients’ Power: All CCGs have a Patient and Public Advisory Group representative (or called something like ‘Patient Engagement’). They differ as to how they find out patients’ views—possibly through area or GP surgery-based Patient Panels. They have no statutory duty to reflect all views expressed—they just have to ensure that patients have been consulted. Nor are they influential enough to affect decision– making at CCG level, except if the CCG is under local pressure, strong enough to withstand the central government / National Commissioning Board’s dictats.

Healthwatch: The public’s opportunity to check what is going on with their local NHS, including whether the CCG’s plans actually work, will move to a new body ‘Healthwatch’, yet to be established in Manchester. Watch this space to see how authoritative and open to public concern it will be…

Openness: All 3 Manchester CCGs hold public board meetings, every second month; the papers are on their websites. CCG meetings I’ve attended have been refreshingly open to questions from the public. However, what happens in the private/closed board meetings? We must ensure that crucial decisions, such as handing services to private companies, are not taken in private. We need to ask questions, maybe by ‘Freedom of Information’ requests, to find out the extent of privatising. Caroline Bedale adds: “That’s just what I’ve done in Oldham, and the full list of private and voluntary sector providers should be on Oldham CCG’s website as a result.”

We need to campaign to keep our NHS public, so that quality health care can be provided by workers in decent jobs with reasonable conditions. This requires political pressure, locally and nationally, from NHS unions linking up with patient groups, local communities, professional bodies and sympathetic political figures on our shared concerns. There are many ways to conduct the fight: in local media, over the internet, on the streets, in the workplace, in the local GP surgery. The CCG may be a focus of our interest in the campaign for a public, quality NHS – but it is not an agent of positive change for us.