A DECISION by a council and clinical commissioning group (CCG) to pool resources together is the "clearest sign yet" that Merseyside's NHS risks being privatised, it has been claimed.

The creation of an integrated commissioning hub (ICH) for Wirral, approved by a joint council-NHS committee on Tuesday, could mean "opening the door" to what's known as an accountable care organisation (ACO).

A subject of controversy after being introduced by the government this year, ACOs bring together most of a local area's NHS services under a single budget, which is then run directly by one organisation – in this case the Wirral Health and Care Commissioning.

But they can also mean private companies entering the market, and so have been likened to American "care models", which only provide limited health care for people who can’t afford private insurance.

A commissioned report investigating financial risks of the ICH, and carried out by PricewaterhouseCoopers last year, said the creation of an ACO would be one way of measuring the scheme's success.

According to Green Party Cllr Pat Cleary, as well as other campaign groups, it's "widely recognised" the ICH could mean a "clear route to privatisation within the NHS", and they urged Wirral council and the CCG not to approve the plans.

Despite the concerns, Wirral council is adamant the move to create the WHaCC will not lead to privatisation.

At a full council meeting on Monday, leader Cllr Phil Davies said the agreement was about reducing hospital admissions and ensuring the CCG’s budget was properly scrutinised.

The plans for WHaCC were approved at Tuesday's meeting of the joint strategic commissioning board at Birkenhead Town Hall, where politicians and CCG officials categorically denied plans to create an ACO.

At the meeting on Tuesday, Dr Sue Wells, medical director of Wirral CCG said the move was "absolutely about integrated care for people, and absolutely not about pushing forward any kind of privatisation in any way".

Cllr Bernie Mooney, cabinet member for children and families said the council "will not take part in anything to do with an ACO or privatisation of the NHS", adding that the wording in the PricewaterhouseCoopers report was "unfortunate and misleading".

It comes after a notice of motion to council this week said the local authority was "opposed to all forms of privatisation in the NHS and totally opposes the introduction of any privateers into our local health service".

But responding to the statement, Cllr Pat Cleary said: "Sadly, if the proposals for an ICH … are adopted then this council will in fact be opening the door to an ACO and health privatisation in Wirral.

"There can be no ambiguity about this. Throughout the [report to be discussed by the committee] there is reference to the development of an ACO and that the ICH is the first step towards this.

"If this contract goes ahead, our CCG will be using it to procure a range of NHS services from April 2019."

He said it would mean a "crucial" switch from needs-based payments to a new "fixed lump sum at the start of each year to cover the costs of a range of treatments for the whole population".

He added: "It means the introduction of demand management and rationing for health services. Fixed capital budgets will be allocated which are no longer based on clinical need and must not be overspent.

"ACOs represent the breaking up of a single national health service into sub-regional care packages with fixed budgets and rationed services."

Describing it as the "clearest sign yet" that Wirral's NHS is at risk of privatisation, he added: "This is not a model we should be rolling out.

"A model that allows for price competition between providers when bidding for contracts leading inevitably to the reduction in quality of care and potentially a Carillion-type collapse. It would decimate the founding principle of the NHS."

Responding to the strong claims, Cllr Davies said: "You are dead wrong, really, with everything you said.

"The agreement you are talking about relates to a bundle of services which have been functioning now for a number of years."

It's hoped benefits of the ICH will include better finances and a reduction in health inequality across Wirral.

That's on top of reduced numbers of hospital admissions and patients in long-term residential care.

Cllr Davies said the council was "equally" against ACOs, but added: "We equally want to make sure the major part of the CCG budget is scrutinised before we enter into any agreements about those issues.

"The agreement you're talking about doesn't have any of those features associated – it will not lead to privatisation.

"The danger is if we don't agree it those people who currently are funded to get out of hospital and into the communities, that funding may be at risk if we don't sign that agreement. So please don't mislead people.

"That agreement needs to be signed to continue to provide those services.

"Let's make sure we tell people what that is about, and not what we've heard here."

The agreement made on Tuesday, known as a section 75, confirmed the pooled funding amount of £129.9m for areas including adult social care, public health and the CCG itself.

It relates to 2018-19 only, and will be reassessed after that period.

Simon Banks, chief officer of WHaCC said: "Our integration is not about privatisation and it is disappointing that its being portrayed as such as this creates fear and uncertainty.

"Our focus is to improve the experience and care of people using health and care services in Wirral and our staff work side by side every day to achieve this aim.

"We can no longer work in isolation as separate organisations and people expect us to work together to improve services. 

"The Section 75 agreement which has been approved today enables us to pool some of our resources and follows existing arrangements such as the Better Care Fund."

It comes amid the controversy surrounding the CCG's proposed closures of the borough’s walk-in centres.

"Those proposals would see more access to GPs and a single Urgent Treatment Centre created at Arrowe Park Hospital.

A notice of motion approved by the council on Monday said it was "totally opposed to any outcome" that would see the closure of the walk-ins.