All posts by kasddh

Wholly Owned Subsidiaries

Paula Sherriff MP for Dewsbury, Mirfield, Denby Dale and Kirkburton has replied to a request for her views on Wholly Owned Companies/Subsidiary Companies/ Special Purpose Vehicles, whatever you want to call them,  in NHS Hospital Trusts.  Her first sentence on the subject starts with the phrase “I am alarmed…..”  so we are not alone.

 Paula Sherriff MP on Subsidiary Companies 

The attempts to dismantle the NHS have been going on for over 25 years.  The changes to legislation inching closer and closer to the healthcare multinationals global policy aims, become clearer when we find the legislation to allow the SubCos, was introduced in 2006, two years before the need to create  the campaign organisation Keep Our NHS Public and probably one of the driving factors in its creation. This is before all but the most eagle eyed of the public,  even began to suspect anything untoward.

Messages released by Government are sometimes contradictory. On the one hand you have a letter to Trusts from the Department of health suggesting these companies are not allowed as a mechanism to save VAT, yet the Trusts using that argument as the main motivator for spending the money to do it. Companies need capital to set up that surely could be used for treatment. Why now?

DoH Tax Avoidance Letter

Yesterday in Leeds the landmark England wide Judicial Review brought by a grass roots campaign group 999 Call for the NHS, against NHS England for its proposed Accountable Care Contract,  was heard. The case examined a point of law, which the group believe is unlawful in the ACO contract and will encourage providers to cherry pick patients rather than provide comprehensive treatment for all, according to need. Since this is already beginning to happen and patients made to wait, such an outcome seems more likely with every passing day. Even if the campaign wins the Judicial Review, NHS England will have suffered a set back but will be able to try again.

The second Judicial Review is about the new health system Government and NHS England want to legalise, with no recourse to Parliamentary debate or public vote.  That is due to be heard on 23rd and 24th May in London.

Dewsbury stall popular with the public

At the street stalls in Dewsbury and Batley many people came over to take a leaflet and sign the petition. The petition is to ask Mid Yorkshire Hospitals NHS Trust Directors, to think again before committing to a SPV as they are calling the potential Subsidiary Company wholly owned by the Trust Board.

https://you.38degrees.org.uk/petitions/stop-the-plans-to-develop-a-subsidiary-company-spv-in-mid-yorkshire-hospitals-nhs-trust

We are hearing that the staff do not want to be ‘divorced’ from the NHS. Members of the public  told us they would post their requests for the Trust to think again, directly to the Trust. The leaflet is in the link below.

85136 A5_2PP_P

 

Campaign Group writes to Mid Yorkshire Hospital Trust to ask them to think again about SPV

Signing the petition on paper on Dewsbury Market.

Dewsbury Keep Our NHS Public, has launched a campaign and petition arguing against a move proposed by Mid Yorkshire Hospitals NHS Trust, to set up a Special Purpose Vehicle (SPV) which would be a new subsidiary Company owned by the Trust Board, in other words a privatisation.   Dewsbury KONP urge the MYHT Board to follow the lead of Bristol’s Southmead Hospital Trust which has scrapped their plans.

https://www.bristolpost.co.uk/news/bristol-news/southmead-hospital-bosses-scrap-proposal-1157104

The campaign group say ” any new company will potentially

  • move staff including cleaners, porters and catering staff not already employed by the PFI company (Public/Private Finance Initiative) into the new company under TUPE regulations. This will split the NHS team, potentially leaving staff feeling isolated and abandoned.

  • offer less favourable terms and conditions to new staff, creating a 2 tier workforce

  • create an extra tier of governance and management

  • potentially and unacceptably move buildings and estates from public, into private ownership at the stroke of a pen.

  • impact on patient experience through lower terms and conditions creating a transient workforce in the future.

Christine Hyde said “The move is likely to have been encouraged by management consultants considering that both Airedale and Harrogate Trusts have already set up a subsidiary company each and Calderdale and Huddersfield Foundation Trust has agreed to set one up too. CHFT, Airedale and Harrogate Trusts belong to the same West Yorkshire Association of Acute Trusts (WYAAT) as Mid Yorkshire. New research indicates that advice from management consultants make the NHS LESS not more efficient. We are keen to alert the Trust to such research and help them resist the enormous pressure they must be under through underfunding and relentless redisorganisation by the Government and NHS regulatory bodies. We urge the Trust not to dismantle the NHS in its 70th year.”.

Liz Twist MP has set up EDM 802 asking the government to block further attempts to set up these SubCos due to the likelihood of them being “short term fixes that will create further problems in the future”. Thelma Walker MP has signed it. Calderdale and Huddersfield Foundation Trust have not as of 22 March 2018, yet lodged their arms length company with Companies House.

 John Grogan MP said of the development at Airedale which went live earlier in the year

“I’ve met Health Minister Philip Dunne to express concerns that if trusts throughout the country continue setting up subsidiary companies there’ll be a big loss of VAT revenue to the Exchequer, which could be used to fund NHS staff pay rises”.

Issues of tax avoidance in relation to these new private companies, have been raised in the Parliament and Stephen Barclay Minister of State (Health and Social Care said .. “the Department has been clear that the setting up of a subsidiary is not a vehicle to avoid VAT.”

David Honeybell said It’s our NHS, funded by our taxes and NI contributions, and that’s how it must stay. We must not allow any part of our NHS to be sold off or transferred to any other body, who ever (sic) sets them up.

Jenifer Devlin said “The assets that will be transferred belong to us and the NHS. They must not be privatised”.

Paula Sherriff MP has been invited to comment but has yet to send a reply. 

A copy of the letter to the Board can be found in the link.

MYHT SPV letter to Board to publish



 

Are Mid Yorkshire Hospital Trust planning to privatise by the back door?

There has been a sudden rash of Hospital Trusts in the West Yorkshire Health and Care Partnership, privatising their estates, porters, cleaners and other staff into a private company wholly owned by the Hospital Trust Board, colloqually known as a SubCo.

https://www.theguardian.com/society/2017/oct/30/nhs-trusts-accused-of-backdoor-privatisation-over-subsidiary-firms

Airedale and Harrogate Hospitals companies went live very recently and the current staff were TUPE’d over to leave their employment in the NHS and become non NHS employees.

Mid Yorkshire Hospitals NHS Trust is referring to the new company as an SPV or Special Purpose Vehicle. We know that there is a similar structure in place to service the ongoing PFI arrangements, which rather begs the question is Mid Yorkshire Hospital Trust going to be taken over in the future by its SPV through some Venture Capital deal?

Paula Sherriff MP has been asked for comment but has not replied yet.

Roy Lilley, respected NHS commentator is worth reading on the subject, here:-

http://campaign.r20.constantcontact.com/render?m=1102665899193&ca=2c4e9b01-156d-4f16-a728-58a3b48732e3

Health Optimisation plan in Kirklees, discontinued

At the Governing Body meeting in common on 14th Feb 2018 of the North Kirklees and Greater Huddersfield CCGs in Dewsbury Town Hall, it was announced that due to opposition to the introduction of the rigid rule called Health Optimisation, preventing people who smoked or had a BMI of 30 or over, receiving elective operations until they stopped smoking for 6 months or had lost a percentage of their body weight, was to be scrapped.
Paula Sherriff MP in a Westminster debate which was mentioned, had noted the enormity of the postcode lottery the measure had created particularly on the border with Wakefield whose CCG did not introduce the policy.
https://hansard.parliament.uk/commons/2017-12-12/debates/E0D6DD11-4E2E-47D0-86AB-A1E4F28698D1/HealthcareOptimisationPlanKirklees

Thelma Walker MP for Colne Valley had drawn attention to the fact that BMI was not a measure of fitness, since people who do sports often have strong muscles and a BMI which is higher than average.
The Health Optimisation Rule  was also opposed by Clinicians in the hospitals.

At the meeting, deprivation between North Kirklees which has more than Greater Huddersfield, was clearly stated in a report by the Local Authority which summarised the most recent Joint Strategic Assesment. Nevertheless a GP from Huddersfield, said he wanted ‘disappointment’ mentioned in the minutes, because the policy was to address health inequality. In the opinion of this blog, it was not. If an  person with a BMI over 30, or smoker had the requisite £10,000 or whatever it cost, there would be a surgeon to perform their operation and the NHS would pick up any problems afterwards. It seems to highlighted wealth inequalities. Watch out for more NHS doublespeak in the future. On the level of health, GPs can still talk to their patients about the advisability of losing weight and stopping smoking.

A question in the meeting elicited the verbal response that there had been no recorded saving from the initiative while it had been running, but later in the meeting a nurse on the Governing Body from the Greater Huddersfield CCG said she had heard the savings were predicted to be considerable. She wanted to know where the money to invest in the services needed to comply with the West Yorkshire and Harrogate  wide ‘Healthy Choices’ instead, was going to come from. It is a good question. Public Health cuts are everywhere.

Integration = Cuts, if Councils’ public health plans are anything to go by.

 

Accountable Care Systems are not the NHS. We are fighting for the NHS not Medicare/Medicaid!

There are now 24 Accountable Care Systems we have identified in England. https://calderdaleandkirklees999callforthenhs.wordpress.com/2017/12/06/24-accountable-care-systems-we-know-about-were-fighting-for-the-nhs-not-medicare/

These are designed to incentivise providers to offer less care. The principle of comprehensive treatment according to need will disappear under these new systems. If you want your children and grandchildren to have the same access to health treatment as you have had in the past, please join us now. Let us know how to contact you via the comments box below.

Act Local, Think National!

We are widening the scope of the campaign.

Has a hospital or ward closed near you? Has your Local Authority’s Scrutiny Committee recently referred the proposals to the Independent Review Panel? (formerly called the Independent Reconfiguration Panel?) If so please will you let us know! E-mail STP_Agony Aunt <stpagony@gmail.com> 

Calderdale and Kirklees 999 Call for the NHS is starting a campaign to get the Independent Review Panel to broaden its terms of reference to include investigating the damaging effects of the government’s “austerity” policy on the NHS and social care; and the effect of Sustainability and Transformation Partnerships on NHS “reconfiguration” proposals. For more info, see Calderdale and Kirklees 999 Call for the NHS – Hospital cuts consultation.

They would be very glad of the involvement of other campaign groups from across England, whose NHS and social care cuts and changes have been recently or currently referred to the Independent Review Panel.

Dewsbury is a case in point.

Dewsbury Hospital’s A&E was rated 6th best in the country in 2012.  Now it’s been downgraded and cannot take blue light ambulances. In the first year since the it opened and the A&E downgrade,  79 women in labour at Dewsbury’s midwife-led birth centre had to be blue-lighted 20 minutes to Pinderfields Hospital because something went wrong.  The Birth Trauma Association (BTA), which helps women who have been through traumatic deliveries, just last week in reference to Dewsbury, said transfers were risky for mothers and babies! – which is exactly why the Joint Kirklees and Wakefield Health Overview and Scrutiny Committee  referred the proposals to the IRP in 2013. Unfortunately the IRP said the changes were ok. They’re not.

A Birth Centre is wonderful…if there’s an A&E next door! Huddersfield birth centre is the next to have its hospital’s A&E cut. Kirklees and Calderdale Joint Health Scrutiny Committee has referred THAT proposal to the Secretary of State.

If you can remember reports in the local news about your hospital cuts, closures and a referral to the Sec of State, please let us know. stpagony@gmail.com

There are now 8000 fewer hospital beds than in 2010. In September this year Simon Wright, Chief Executive of Shrewsbury and Telford Hospitals, said

I think is it really important we remember that the best solution is to keep both A&E departments open’.

And he is right. Please let us know, and share the petition….Thank you

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

We do not want to go back in time!

Managed neglect.

The Care Closer to Home agenda, so vaunted as the best thing since sliced bread, at the Meeting the Challenge Consultation, in 2012/13 is being rolled out apace.

The actual Care Closer to Home contract was won by Locala, where the company has increasingly, along with Hospital Trusts, suffered from a staffing crisis and the CCG has said it has recognised it has suffered challenges. But the majority of contracts in England, seem now, to be removed from hospitals. Since 2013, 86% pharmaceutical contracts have been won by non NHS organisations, 83% patient transport contracts won by non NHS organisations, 25% mental health contracts won by non NHS organisations, 76% diagnostic contracts won by non NHS organisations. Where are the costs to patient care being tallied?

Wheelchairs in North Kirklees were outsourced to Opcare. Unless we stop it, the NHS is moving towards a single, inflexible, capitated budget as 44 or so Accountable Care Systems or Organisations. What happens when a budget is capped, is nicely demonstrated by the wheelchair contract. Lauded by the CCG as the best provider for the job, having previously been an expert company moulding prosthetics and devices for disabled people, the company is not able  to fulfill  the expectations of local people who need wheelchairs.  Anecdotally we hear that children with wheelchair needs are measured, but wait so long for it to be delivered, that they have outgrown the chair by the time it arrives. In another case the child is presented with a chair without the necessary straps to regulate the body to a correct posture, so the parents have to resort to tying the child in with string! The company it seems allegedly tells parents it does not have the money to correct these situations. Extrapolate these occurrences over the whole of West Yorkshire including the complete spectrum of health disorders and you begin to get a sense of how damaging to people, a per-capita system will be.

Dermatology referrals, when the GP thinks you may not have a skin cancer but are not quite sure, go to Priderm LLP,  a community business in several GP practices in North Kirklees. Registered with the CQC in 2013, it has not been inspected yet according to the CQC website.  It is another layer of ‘the market’, which comes between a hospital specialist and a GP.  The contract seems to be covering the costs, but it hard to see how it can be cheaper than specialists in a hospital, when you think of the Priderm manager, contract expert, receptionists, venue hire and the cost to the CCG of another contract to assure compliance with. Of course in the future, a receptionist with a list of tick box questions will direct you to this company or not, depending on the criteria on the tick box list.

Mid Yorkshire has ‘delivered’ the Meeting the Challenge changes.

When Government says ‘jump’ organisations have to say, ‘How high!’

Posted on

https://midyorks.nhs.uk/news/september-ahr-update-2078

This three year programme to transform hospital care across North Kirklees and Wakefield is now at an end and we monitor how the redesigned services are bedding in.

This came to an end on Sept 4 as changes to acute medicine services at both the Dewsbury and Pinderfields hospital sites were delivered. This means Pinderfields Hospital is now The Mid Yorkshire Hospitals NHS Trusts centre for acute and critical care services and allows Dewsbury and District Hospital and Pontefract to become centres of excellence for rehabilitation and elective care.

We have achieved a lot over the three year length of the programme.

2014

  • Ambulatory emergency care service in Dewsbury offering rapid access to diagnosis and treatment without the need for hospital admission
  • Children’s assessment unit opens in Dewsbury

2015

  • Ophthalmology centre opens at Pinderfields
  • Acute cardiology services were centralised at Pinderfields resulting in faster transfer to specialist care and shorter lengths of stay

2016

  • Midwife-led birth centre opens at Dewsbury.  All births requiring a consultant were centralised at Pinderfields
  • Neo-natal services and children’s inpatient care centralised at Pinderfields

2017

  • Transfer of inpatient care for acute medical patients from Dewsbury to Pinderfields.

We now have a model of care that is safer and more sustainable for local people and new services include:

  • Opening of the new Acute Care Unit (ACU) on gate 27 at Pinderfields
  • Two new Acute Care of the Elderly (ACE) Frailty assessment units at Dewsbury and Pinderfields  This is a dedicated service for elderly care focusing on rapid assessment; treatment and helping people with frailty get back home as soon as they are well enough
  • The development of a Clinical Decision Unit at Dewsbury, where patients would be admitted for a short time (normally under 12 hours) for tests and initial treatment before being discharged or transferred to a ward
  • Increased rehabilitation at Dewsbury and Pontefract Hospitals
  • Opening of medicine and elderly care step down wards at Dewsbury and Pontefract for people who are out of the acute phase of their care episode but not yet able to go home.

By putting specialist and critical care onto one site means the most seriously ill patients get faster access to senior clinicians with the right skills who are located together.  This means patients who are seriously ill are more likely to make a good recovery.

Dewsbury Hospital continues to have a 24hrs a day A&E Emergency Department. It can treat any patient who comes through the doors with a life threatening medical emergency such as head injuries, severe bleeding and cardiac arrest. If there is a need for a hospital admission this may lead to a transfer to the Pinderfields site.

Dewsbury A&E is not an Urgent Care Centre which is limited in what it provides and usually provides patients treatment for issues that are not life threatening such as broken bones and animal bites.

Please feedback your thoughts on our redesigned hospitals services offer through our dedicated email address: betterhospitals@midyorks.nhs.uk

It’s Go, for the downgrade to Dewsbury District Hospital starting on 4th September.

The North Kirklees CCG Governing Body heard on 30 August 2017, that the CCG’s conversation with Yorkshire Ambulance Service (YAS) had given them assurance that there was enough capacity, that is as many ambulances,  drivers and paramedics as was needed, to make extra journeys necessary due to the withdrawal of acute medicine services from DDH, possible.  The Governing Body did not hear that YAS had given the CCG written assurance! Nor did the campaign group have much confidence in anyone’s assurances, when a member of the group said a person they knew had been discharged from the A&E at DDH with a broken hip, due to the refusal to do an x-ray of it,  on the very day of the CCG Governing Body meeting and the following day when an ambulance was called, they had to wait over 2 and a half hours for it to arrive.  Of course they were taken to Pinderfields because as the ambulance staff said, “We will be severely restricted as to who we can take to Dewsbury Hospital from next week.”

Possibly that person in the Pinderfields bed, did not see the representative from the North Kirklees CCG on BBC Look North, explaining how the service was  ‘improved’ at Dewsbury today (1st September)!

Other people have had great service at Dewsbury A&E, in and out with a broken wrist, x-rayed, plastered and discharged within an hour, for example and the nurses and doctors friendly and helpful.

This downgrade, is a systemic problem brought about by 7 years of  deliberate underfunding, lack of workforce planning , fragmentation,  under investment in every area of doctor and nurse education and training, public denigration of dedicated doctors and nurses and all to dismantle the NHS as a whole.

What is happening in Nottingham is a scandal and disgrace.

Centene Corporation contract with Nottingham NHS organisations is £2.7m can of worms

If you have frustrating experience of Dewsbury’s A&E please let us know via the comments box.  We had permission to mention the patient story above. We will never publish anything which has not had permission from you, in writing! Thanks.