Truth will out, even in a post truth age.

Response to the STP update at the Health and Wellbeing Board meeting on 24th November 2016.

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OLYMPUS DIGITAL CAMERA

Dear Cllr Viv Kendrick

Further to the Health and Wellbeing Board (HWBB) meeting and the update by STP Lead Rob Webster, I would like to take this opportunity to make a few points about his statement and also pose some questions.

He says in the briefing, that the local Healthwatch is involved “to plan how best to meet the needs of local people, thus ensuring local people have a strong voice”. Please answer how this can be?

Healthwatch compiled an award winning report a couple of years or so ago about the lack of NHS dentistry in Dewsbury. Everyone involved complained, it was not good enough, an MP called for more provision! Has this addressed the needs of local people, was their strong voice heard. Emphatically, No! There is still no NHS dentistry in Dewsbury and indeed there is a rumour that the third world charity which was doing some emergency dental work, has left to go to Bradford. Rob Webster’s own mental Health Trust at it’s Consultation on it’s move to Care Closer to Home in March 2015, said that they could not match the Locala single point of access time of 2 hours between phone call to home visit and it would have to be 4 hours. There was no room for negotiation. The SWYPFT Care Closer to Home, involving nurses traveling to patient’s houses 4 times a day to give drugs, was challenged as an expensive way to carry on at the time, and the answer was that they were not doing it to save money. So why were they doing it? Why are they going to be doing it? They could not give an adequate answer at that Consultation about the change but the hospital beds are still being removed as far as I know, even though Rob Webster gave an undertaking on 24th, to have no patients moved out of area.

Dr Kelly at the HWBB meeting challenged the discrepancy in underfunding figures given in the report. We have no way of knowing which assumptions were made about what and can have little concept of the financial underpinning of the plans, until the spreadsheets are published. At a Kirklees CCG meeting earlier in the year, the STP transformation budget revealed then, amounted to around £2m which spread between 11 CCGs is peanuts. So how can we have ‘a strong voice.’

The pockets of deprivation mentioned in the plan, are definitely in North Kirklees and some areas of South Kirklees. While mentioning the deprivation and affluence determining life chances, the plan says nothing about social conditions and environmental pollution which are determinants of ill health. Closing the so-called Gap needs bullying, isolation, poverty, poor quality food, lack of education, air, water and food pollution to be removed, and good quality, safe, accessible parks and green space put in. The plans look at a small silo of measures for prevention but until they address the wholeness of these aspects of life in a deprived area, are the outcomes going to be any better? Especially in formerly wealthy, healthy areas in North Yorkshire and Denby Dale area, now designated as suitable sites for fracking and all the likelihood of pollution attendant on that. (Sellafield had accidents at first and milk, land and sea, were affected by radioactivity so do not believe claims it is not possible.)

I challenge the paragraph, beginning “It’s great news that people are living longer.” There is then an exposition “the reality is” but the paragraph is not talking about a reality, because the end of the paragraph is “2/3 of people COULD spend their retirement years in ill-health” (my capitals) They could, or they could not! The whole construction of this paragraph, is to mislead. The truth is that the majority of people use the NHS most in the last 2 years of their life, whether that life finishes at age 50 or 90.

Are you tired of being blamed for the underfunding of the NHS? I am. An aging population! It is an excuse. It is not my fault that my parents wanted a child.There are an increasing number of babies and young children too by comparison with the 1980s.

Working together differently means outsourcing NHS services in the same way that Care Homes and social care has been outsourced. Can you hand on heart say that such a move has been an unmitigated success? (see the link at the end.)

I hope you rise to the challenge Rob Webster has repeated again, about Health and Wellbeing Boards providing a way of ensuring local people have a strong voice and not only that, but that it is listened to and acted upon.

standard_method_of_preparing_nhs_for_privatisation_by_chomsky

How are you going to support the West Yorkshire Council Leaders who refused to endorse the STP in their letter to NHS England and also how are you going to put into effect the Council’s unanimous rejection of the STP at a recent council meeting?

As we have learned at the Meeting the Challenge, and also at the Right Care Right Time Right Place, by the time a Consultation is launched, all the ‘Authorities’ can do in response to public outrage, dissent or disagreement, is decide what colour the door is. Your support is very valuable. Thank you.

https://chpi.org.uk/wp/wp-content/uploads/2016/11/CHPI-SocialCare-Oct16-Proof01a.pdf

This article looks at assumptions in the STP plans, which are the same in all of them not just concentrated on London:-

https://chpi.org.uk/new-report-reveals-radical-healthcare-changes-planned-east-london/

Also an investigation into Patient Voice in the NHS and how it has been silenced, here:-  https://nhspublicvoice.wordpress.com/

Board Papers and STP update here:-https://democracy.kirklees.gov.uk/documents/g5117/Public reports pack 24th-Nov-2016 14.00 Health and Wellbeing Board.pdf?

http://www.independent.co.uk/life-style/health-and-families/health-news/dentaid-third-world-charity-steps-in-to-help-britains-dental-crisis-a6803106.html

National Day of Action! Vigil; 3 December; Halifax Road entrance; Dewsbury Hospital, 11:30 to 12:30

Drop by and tweet one!
Drop by and tweet one!

The so called Sustainability and Transformation Plans are dressed up as 2 things, the first as a way to implement Simon Stevens, Boss of NHS England’s 5 Year Forward View and second as a way to cut costs due the huge underfunding of the NHS, lied about consistently by both Hunt and May.
https://www.hsj.co.uk/topics/finance-and-efficiency/statistics-authority-intervenes-over-government-nhs-spending-claims/7013488.article?blocktitle=Most-popular&contentID=-1
What they will actually do, is being kept secret. In spite of the STP Lead Rob Webster from the West Yorkshire Footprint number 5, saying it is not a vehicle for privatisation, the guidelines from NHS Improvement show that there will be a significant emphasis in the evaluation of CCGs performance, on their success in ‘outsourcing.’ Rob Webster talked at the Health and Wellbeing Board on Thursday 24 Nov about ‘delegating’ and for the delegates to be still under your control, but we all know that this costs money, involving a huge amount of oversight by contract, performance, governance and operational experts.
And still Serco managed to defraud the NHS on more than one account.  There are questions surrounding dubious practices at a company locally and the US arm of one of the companies with contracts for both Commissioning Support AND providing services in and around Brighton and Hove, has been successfully prosecuted for fraud in the US. The opportunity for conflicts of interest has never been greater.
More information about STPs and their effects here:-
http://www.stopthestps.org.uk/stp-effects/4593180601
If you’ve never been to anything like this before, give it a go, especially if you have a ‘phone which takes photos. Drop by and tweet one. We are looking to make lots of tweets. #stoptheSTPs

Resistance to publishing the financial, activity and workforce appendices to the STP plans is widespread, and even an FOI has been rejected. Even Chairs of Health and Wellbeing Boards do not realise appendices exist.

The shift away from NHS accountability to the public is obvious. People need to know. That’s why we’re  organising a get together outside Dewsbury Hospital for an hour and give out leaflets to passers by on the  National Day of Action, 3 December 2016, at 11:30am, although other actions start from 10am. (Look out for other actions on the facebook page, there are actions in Barnsley and Halifax so far). This will be a few days before signing of the 2 year contracts happening on 23 December.

More information is on the website https://www.stopthestps.org.uk and  digest of the plans follows below.

See the facebook page https://www.facebook.com/events/1016971921782232/

There is no need to underfund the NHS, it is a political choice. We are the 6th richest country in the world, yet we already have fewer hospital beds per 1000 population than all the EU counties bar one!

Share the message.

stp-final-nicwattsv3Digest of the West Yorkshire STP:

  • Imposition of “new care models” based on American private health care systems,
  • Creation of public-private partnerships via US style Accountable Care Organisations for community/primary care, also involving Hospital Trusts in some areas.
  • Big changes to governance and commissioning (that will cost a lot of money spent on spent on consultancy companies)
  • Workforce upheaval including introduction of new low skilled grades of staff including big charities and unregistered staff and retraining existing staff to carry out new roles,
  • Restriction and withdrawal of services/treatments, mainly elective services and drugs/ specialised foods/drinks
  • 7 day working – with no attempt made to address all the unresolved issues about this
  • Patients’ self care – to cut £1m costs
  • Behaviour change programmes for obesity, smoking, alcohol abuse and diabetes prevention (that ignore the social, economic and environmental determinants of these health problems)
  • Lots of digitech
  • Reconfiguration of acute hospital services – ie A&E mostly only vaguely referred to but: a cut to the number of hyperacute hospitals and referred to as centralisation.

Chrissy P had never done anything like a rally before, but gave it her best and created a huge success.

https://www.facebook.com/chrissie.a.parker/posts/10211399445811031

Drop by and tweet one, or two, or even 3!
Drop by and tweet one, or two, or even 3!

Oh, and sign the petition:-

https://you.38degrees.org.uk/petitions/stop-the-plans-to-dismantle-our-nhs

The West Yorkshire Sustainability and Transformation Plan (STP) has been published.

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People across Kirklees and Calderdale have been writing to Councillors to ask them to refuse to endorse the STP for West Yorkshire because it has been worked up in secrecy and clinicians and GPs have had no say in it.

West Yorkshire and Harrogate Sustainability Transformation Plan

A new BMA survey has revealed that over two thirds of doctors say they have not been consulted on STPs. The survey also shows that a third of doctors have never heard of STPs and a fifth do not support the introduction of the plans.

BMA analysis has found that NHS sustainability and transformation plans (STPs) will have to deliver £22bn in cuts by 2020/2021 in order to balance health and social care spending across 44 ‘footprint’ areas, raising serious concerns about cuts to services and the impact on patient care.

Officials in each area have been asked by NHS England to predict in their STPs the financial hole they face in their budgets and set out how they can close it. The savings figures were found in papers from 42 of the 44 areas across England.

standard_method_of_preparing_nhs_for_privatisation_by_chomskyCampaigners for Dewsbury hospital have found that the reductions in A& E provision had been planned for much longer than had been realised at the Meeting the Challenge consultation and that the plans for further cuts had been shelved as politically sensitive before the last election in 2015. However, STPs have brought the plans off the shelf and more cuts are in the pipeline, for all areas. We have seen this in the devastating proposals for Huddersfield Royal Infirmary, which are featured in the STP.

Although the plans have been published in West Yorkshire there are no financial, activity or workforce plans in the public domain, which were also submitted to NHS England as appendices. Campaigners are asking their Councillors to press for the publication of these documents, in order for the public to be able to see the cuts and redisorganisation to come.

Model letter to Councillors.

Dear Councillor……………….

Some time ago, I emailed you asking you to urge the West Yorkshire and Harrogate Council Leaders to publish the West Yorkshire and Harrogate Sustainability and Transformation Plan.

This STP has now been published. However, although according to NHS England guidance it is the Final STP for operational delivery of the plan in 2017/18 – 2018/19, it seems that the published version is not the complete version. It lacks any appendices with detailed information about:

  • finances,

  • workforce,

  • the move to turn the Alliance of Acute Hospitals into a foundation group and what that will mean for the reconfiguration of acute hospitals across the region

  • how and when the big changes to NHS governance and commissioning are intended to take place and how and whether the proposed establishment of accountable care organisations or systems are likely to conflict with current legislation governing NHS governance and commissioning, and if so, how that is going to be dealt with.

I therefore am asking you to use your powers to make sure that publication takes place swiftly, of all the missing appendices and any other related documents covering these and other topics that have been sent to NHS England along with the published STP.

Further, since the West Yorkshire and Harrogate STP – if implemented beyond the current initial year – will have a significant effect on the area’s NHS and social care, please will you demand that a footprint – wide Joint Health Scrutiny Committee is immediately set up and that it sets about the task of scrutinising the STP at once.

The Harrogate Examiner reports that http://www.harrogateadvertiser.co.uk/news/health/1billion-funding-hole-in-harrogate-district-s-healthcare-1-8243376 the N Yorks Health Scrutiny Committee is not happy about the WY & Harrogate STP but has no means to scrutinise it alongside the other Councils that are affected by it, since the Joint Health Scrutiny Committees are not coterminous with the STP footprint. This is clearly daft.

I hope you will take it upon yourself to protect the NHS and social care in our area by making sure that ALL the STP information that has gone to NHS England is published

Yours sincerely

 

For more information see

https://you.38degrees.org.uk/petitions/stop-the-plans-to-dismantle-our-nhs