Fake Consultation – Report from Canterbury

On September 10th, 2019, there was an NHS meeting in Canterbury called ‘Bringing the NHS Long term Plan To Life’. 4 SONIK activists attended and took part in the discussions. We live tweeted from the event, so if you are on twitter, have a look – @saveournhskent and @mt_cj_rams . Oddly, there was no presentation about what the LTP will mean for Kent, and when we tried to ask, we got few answers. Instead, we were all seated at tables with topics such as ‘Cancer Care’, ‘Primary care’ and so on, and asked to participate in a blue sky thinking exercise about what would improve services. The discussions were guided onto safe and easy topics by the facilitators (3 to each table).
     The facilitators noted responses selectively (except where prompted) and discussions frequently went outside the NHS remit. on the ‘Children’s Services’ table, the discussion was dominated by discussions about schools rather than children’s NHS services. I tried to bring up changes to apediatrics services in hospitals, asking if inpatient beds would be cut, but was told that that wasn’t being discussed. I brought up the two year CAMHS waiting list, but that was quickly replaced as a topic by schools again, and also London hospital care at Great ormond St. Anything but a discussion related to Kent’s NHS services. This was encouraged and instigated by the facilitator.
     Two women spoke to me just before they left, saying “we didn’t get to talk about what we wanted to talk about. We wanted to talk about hospitals.”
     There was no presentation about the actual changes that are happening as a result of the LTP – the structural changes which are actually quite crucial – couldn’t be discussed as there was no table alloated for that. This event will be counted as a ‘consultation’, and those who attended will be regarded as having been consulted. But it was an exercise in distraction and evasion.
     A survey about the merger of Kent and Medway’s 8 CCGs into one CCG for the whole region was not up for discussion and paper copies were on a side table rather than being given out (or put on the tables where we were seated) along with all the other leaflets and printouts. most attendees will not have picked one up. The survey deadline is Sept 23rd – 12 days away.
     The CCG merger ought to have been presented and explained, positive and negative implications should have been outlined, and then people should have been handed the survey and encouraged to respond. Instead, attendees were blue sky thinking and brainstorming in a meeting that was ‘world cafe’ layout from start to end (ie separated into groups on circular tables). Each table had a proscribed discussion going on and talking points which facilitators used to prevent discussion of other topics. it was all very fluffy and optimistic, but with no real link to thereal world, ie what is happening to our services now and what is is being proposed.
     At the Cancer table, the discussion was largely about how we enegage people to attend cancer screenings. I tried to ask if cancer services will be centralised, but the facilitator didn’t know. i pushed him for answeres and he gave what he thought was a likely scenario, but he could not provide any details on the draft plan. The table had 2 facilitators, a pharmacy contractor, 2 lay members of the public and a retired NHS administrator who had worked in cancer screening. We were all asked to state if we agreed with a vague and optimistic sounding statement about cancer care. I said that we shoudn’t be asked to approve unfinished plans with no detail. The statement sounds very positive but buried with in it is the suggestion that cancer patients will not any longer have routine appointments with their consultant or cancer nurse.
     There were about 12 tables in the room, and the din of so many people talking at once made it very difficult for most to hear what was being said by anyone.
     At the mental health table, the facilitators told another attendee that she couldn’t talk about the proposed closure of St Martin’s mental health hospital in canterbury. As there were two of us that wouldn’t be shut up, they had to give in to some extent, but they put up a lot of resistance to talking about the suicide epidemic in Thanet, the failings to provide an adequate service acrosss kent, and anything to do with the situation as it stands. Talk of underresourcing, cuts and the fact that lots more paid and qualified MH professional are needed was met with blank looks. They wanted to talk about fluffier topics, such as prevention and engagement – not the nitty gritty.
     The mental health facilitators would say things like ‘it seems to me that what you’re saying is that it’s all about education”, or “what I’m hearing is that we all agree we need a consistency of service across areas”. I have a strong suspicion that that is what will be recorded as the upshot of these meetings. It seemed as if the facilitators knew what they wanted us to say, and they were going to be damn sure that we said it.
     Lastly, I went to a cancer table with a different facilitator. She was a very pleasant woman from the Kent cancer alliance (new groups that report to NHSE). This table had 2 facilitators, Liz Shutler (Director of Strategic Development, East Kent Hospitals Trust), 2 SONiK campaigners (including myself) and a man that joined halfway through the session. The lady from KCA wanted to talk about a chemo bus that could treat people at home, why people don’t opt to get screened for cancer, how it’s much nicer to be treated at home and the new referral to diagnosis targets that will come in next April. As Liz Shutler was at the table, I took the opportunity to ask about the funding. Improvements need to be paid for, so I asked what news there was about Javid’s ‘spending review’ which promised at lot more money for the NHS; how will this be filtering down to Kent and medway? “I don’t know the answer to that, i’m sorry” and she said I should write it down to be answered later. I then asked if anyting had filtered down from the extra money promised by Theresa May – again she said she didn’t know and wt know and I would have to register it as a question (ie write it down, which I did). I expressed my surprise that nothing had been prepared on this to share at a meeting entitled “Bringing the NHS Long Term Plan NHS to Life”, and also my surprise that such a senior figure couldn’t confirm if there was extra funding coming and where it might be spent. I was told “I’ve answered your question”, “the CCG might know” and “you’ve logged the question, it will be answered”. She also said she didn’t know if the NHS in Kent had recieved any new funding during the current financial year.
     Liz couldn’t say where the answers will be published. I ointed out to her that that promise has been made and broken at NHS consultation meetings before; she insisted that this time it won’t, and the she will see to it that the questions are answered this time.
     We also asked why golden hellos can’t be used in Thanet, where we are told that services must be closed as staff can’t be attracted to the area. Again, staff areneded if we are to make improvements, so a pretty valid question. Liz said “we have offered incentives to people … incentives are used” but that she didn’t know about “cash sums” being offered. I asked what the other incentives are, and was told again to “log the question” as she didn’t have an answer.
   At this point the man to Liz’s right started asking about ‘options one and two’, ie the plans to reconfigure A&E, maternity and other services in east Kent. Liz said “that’s not what we’re here to talk about tonight”. The man pushed the issue, and Liz looked decidedly unhappy as she tried to argue why she wouldn’t answer questions on the topic.
     We’ll have to wait and see if any of our questions get answered in due course. Will the opinions given be logged accurately? We don’t know. It’s quite clear that the point of last night’s meeting was box ticking; they needed to get a ceratin amount of people in a room, and go through the motions. They also needed to get people to agree with the bland statements about making changes. We know this, because the technique was used in the stroke consultation. They can say “xx% agreed with our plans” later on when things get controversial. It won’t matter that those people agreed to an undefined ‘plan’ in the form of an upbeat, positive statement of loosely expressed intentions. They will play it however it suits them.
      Manipulation is what these exercises are about, and Kent and Medway NHS leaders are highly practiced in carrying them out.