The meeting was OKish: the beginning of a dialogue about how local provision will now be planned and delivered. I went along with a series of questions of which I only had time to ask a couple from the floor of the meeting. Thankfully, the Board agreed to address my questions in due course and they said they will get back to me. I await their answers.
In the meantime, I thought I would publish the questions, as I think this has bearing upon police commissioned services as well. If this private sector involvement in core policing takes off in a big way, we all need to be prepared to scrutinise the details of the deals - just as much as we need to for our health service as well.
1. How will public health now be organized – is there any risk that services which have been free hitherto – may be charged for in the future?
2. How often will you be holding public meetings? Will the next one be in Buckingham?
3. How will you appraise the health needs of the local population that you serve?
4. How much is the change costing us the taxpayer to establish these new commissioning arrangements?
5. When will you publish a list of interests of the members of the AVCCG?
6. What is happening regarding the commissioning of private sector suppliers – what plans have been put in place so far? How will the public be kept in the loop with what is occurring?
7. What arrangements will you be putting in place to liaise with the parish and town councils in the area you cover?
8. How will we be able to judge the success of these new arrangements? What success indicators are you putting in place and where will these be publicly accessible?
9. If you do commission local health services from (say) Virgin – as has happened in Surrey, can you confirm that the FoIA will apply to any contracted party and make this a condition of them bidding?
10. Similarly, if a private contractor invents some new clinical method, can you confirm that the public will own the IPR and not the contractor as we will have paid for its development? Will you make this a condition of any tenders / contracts from henceforth?
11. How much will members of the AVCCG be paid?
12. If commissioning involves looking at value of various bids to provide healthcare services, please will you confirm that you will look at the whole value of such bids to the taxpayer? For example, what are you views on bids which come in with lower staff costs as a consequence of lower pension costs in the future whilst recognizing that the state may well pick up the tab if those same people need extra benefits when they retire?
13. What action will you take under EU and other competition law to prevent "commercial in confidence" acting as a barrier to the CCG selecting the tenderer with the most value for money?
14. What arrangements will you be making to ensure that bids from private sector suppliers are discounted to allow for the loss of the past investment in human capital by the state from the transferring of highly experienced and fully trained public sector staff to the new private sector suppliers?
15. What commercial clauses will you insert into the final contract so that any remaining public sector staff (especially those on the commissioning side) can continue to innovate and invent new ways of doing business without incurring disproportionate penalty costs from private sector suppliers?
16. How will you genuinely commission on outcomes and results: and ensure that the public/service users have a good say in the appraisal of the new provider and are able to tell all concerned loudly whether those outcomes and results have been achieved well or not?
17. What mechanisms, will you install in the commissioning process to ensure the winning bidder is not likely to become an organisation with high staff turnover, low morale and low wages which risk costing the taxpayer more?
18. How will you shape and install measures, targets and objectives in the process and final contracts which generate superlative levels of service & outcomes and not the target equivalent of clock-watching?
19. How often will the AVCCG meet in public session? Will it be possible for members of the public to address these meetings?