Labour leadership, the NHS, and ‘honest politics’ by Caroline Molloy

Labour leadership, the NHS, and ‘honest politics’

Caroline Molloy 16 September 2016

This piece is republished from OurNHS open Democracy with kind permission

https://opendemocracy.net/ournhs/caroline-molloy/only-article-about-leadership-campaign-i-ll-write

We need to take back control of our NHS from the unelected technocrats and their health industry friends – and politicians brave enough to say so. What about the Labour party?

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As the Labour leadership campaign enters its final week, the Tories are getting on with the job of dismantling the NHS.

As the Labour leadership campaign enters its final week, the Tories are getting on with the job of dismantling the NHS.

On Wednesday Shadow Health Secretary Diane Abbott warned fellow MPs the government was “planning for disaster”, in an opposition day debate on drastic plans to cut frontline NHS services, so-called ‘Sustainability and Transformation Plans’ (STPs). Abbott slammed the secretive plans, saying they were being “presented as a drive towards medical prevention” of ill health, but the planned savings “could only be achieved by preventing access to the NHS”. And she warned the plans were a “stalking horse” for privatisation, praising “the work of organisations such as openDemocracy and 38 Degrees” for ensuring that “the picture of what STPs will mean is becoming clearer”.

STP Plans

NHS boss Simon Stevens has warned local NHS managers that if they don’t promise the required level of frontline cuts in their STP plans, they face their organisations being put into ‘special measures’ and taken over by more compliant leaders. Too slowly, the media are waking up to the fact that the £22bn a year funding shortfall accepted by NHS boss Simon Stevens at the behest of his Tory bosses is going to mean eye-watering cuts to hospital services on the ground. Chris Hopson of NHS Providers admits a ‘glut’ of hospitals could close.

Stephen Dalton of the NHS Confederation defends the plans, saying they “are not about cuts” and suggesting local NHS managers and politicians will “do their best to reflect local needs and will want the wider community to be involved in the conversation”.

But – as yesterday’s Commons debate made clear – that’s not what’s happening.

Cheshire & Merseyside ‘STP’ bosses tell NHS campaigners that they can only see the plan and be consulted on it “when the plan has been agreed” by NHS England, and that STP planning meetings “are not held in public and the notes from these meetings are not published”. NHS campaigners from Bristol to Brighton, Cumbria to Gloucestershire have had their own requests for information similarly rebuffed.

And when Shrewsbury & Telford NHS bosses published their STP plan they were rapped on the knuckles by NHS England’s regional director who told them that STPs “should not go to Board meetings… they are not meant to be published at all…they are highly political and highly contentious”.

So if NHS leaders are not having any meaningful conversation with the public to help them ‘transform’ the NHS – who are they talking and listening to?

Surviving Blairites

This summer, the self-styled ‘soft left’ have been busy reassuring Labour members that if they kick out Jeremy Corbyn, there’s absolutely no risk of another takeover by Blairite MPs. Blairism is so over, they opine, and everyone is a socialist now. Even Tony Blair himself chipped in to suggest that Blairism had ‘had its day’.

Paul Mason has warned us that on the contrary, many prominent right wing Labour figures have only gone quiet because they are biding their time before launching a renewed counter-attack. Probably true.

But there’s another side to this story, too.

In this post-democratic age, being an MP isn’t really where it’s at. This is certainly the case in the NHS, where the 2012 Act removed any legal duty on the Secretary of State to secure or provide comprehensive healthcare. Now, our MPs don’t even have the right to know, for example, what contracts disgraced contractor G4S holds with the NHS. Instead, decisions about running, cutting or privatising NHS services are handed over to the technocrats, whilst Jeremy Hunt stays out of sight. (The Health Secretary didn’t even bother turning up to yesterday’s Commons health debate!).

So who are these technocrats shaping our post-democratic NHS?

An astonishing number of them worked as advisors to Tony Blair.

In charge is NHS boss Simon Stevens, formerly Vice President of US private health giant UnitedHealth. As special advisor to former Health Secretary Alan Milburn until 2001 and then directly to Tony Blair from 2001 to 2004 Stevens was the architect of the 2000 NHS Plan which re-established the ‘internal market’, and the ‘concordat’ which opened the door to private health firms running NHS services. Under him, running the Sustainability and Transformation Programme is Michael MacDonnell – who succeeded Stevens as an advisor to Blair in his Delivery Unit. MacDonnell recently boasted of the ‘enormous opportunity’ the STP plans offer the private sector. A slimmed down, reconfigured frontline less focused on hospitals, and overseen by management-heavy restrictions on referrals and staffing, are clearly appealing to the private firms which already dominate the ‘home care’ market and NHS ‘management expertise’.

The ‘efficiency savings’ across the NHS (labelled as ‘unrealistic’ and ‘damaging’ by the Public Accounts Committee) have been driven by NHS Improvement’s predecessor, Monitor for several years. From 2011 Monitor was headed by David Bennett, who moved from McKinsey to work as head of Blair’s Strategy Unit from 2005-7.

Then we have the consultants. There are the familiar faces of PWC and McKinsey, involved in helping write the fantasy plans at local level.

But there are less familiar faces too. Kieran Brett – another former Blair advisor – now heads up ‘STP consultancy’ at iMPower. Brett was recently in the spotlight when his firm held a rather lavish reception to promote their services to local NHS bosses – with the star ‘draw’ being the chance to schmooze with Brett’s former-colleague-turned-STP-boss, Michael MacDonnell. The connection is closer than that – Brett, MacDonnell and David Bennett also founded a think tank together.

OurNHS’s FOI requests have exposed that another consultancy advising STP bosses is GE Finnamore – the health consultancy recently bought up by General Electric. GE Finnamore works with yet more former Blair era figures including ex-Blair health advisor Paul Corrigan, who played a key role in forcing hospitals like Mid-Staffs to rush to adopt Blair’s flagship NHS policy of becoming ‘business-like’ foundation trusts, with disastrous results. Another Finnamore associate is Simon Stevens’ former colleague at the Department of Health, Sir Neil MacKay. MacKay founded the NHS’s specialist privatisation unit, recently closed down after a string of disastrous collapses, from Hinchingbrooke to the UnitingCare contract. He’s now running the ‘Success Regime’ (ie, special measures) in Cumbria’s NHS.

Such figures were key in the setting up of the ludicrously wasteful NHS ‘market’ from 2000 onwards, introducing the flawed foundation trust model, wrecking GP contracts and out of hours services, pathology, and more.

And at least two Blairite peers – Lords Warner and Carter – also continue to be actively involved in promoting NHS cuts and privatisation.

Owen Smith, in his main campaign NHS speech, suggested New Labour had been “naïve” about the extent to which its NHS policies opened the door to further privatisation. But the ongoing survival and influence of these men (and the lucrative post-politics careers of former New Labour health secretaries like Alan Milburn and Patricia Hewitt) suggests that they knew exactly what they were doing – or have adapted very happily to their outcomes, nonetheless.

Anti-Corbyn plotters and their healthcare links

This summer, the campaign to unseat Corbyn brought to light still others who’ve done well from a health market in which they can flog consultancy, research, and patient ‘segmentation’.

Folks like Reg Race, former Labour MP and donor, who is the man behind the anti-Corbyn ‘Saving Labour’ project. Race’s ‘Quality Health’ firm made its fortune from supplying the survey systems set up by Labour health ministers in 2003 to facilitate the newly ‘marketised’ NHS.

And Chris Powell – chair of the Portland Communications agency that has been implicated in some of the moves to oust Corbyn. Powell currently chairs Dr Foster, the outfit that pioneered a consumerist approach to repackaging and selling NHS data and was rewarded with a highly controversial sweetheart deal by New Labour health ministers.

Then there’s Joe McCrea – who registered ‘Angela 4 Leader’ a few days before the anti-Corbyn ‘coup’ started. McCrea started out as yet another health special advisor during the Blair government, working alongside Simon Stevens. He now earns much of his income from consulting on the ever-expanding array of NHS digital/data initiatives.

Most notably, perhaps, a key donor to the new anti-Corbyn group ‘Labour Tomorrow’ is one Martin Taylor. Taylor was exposed in 2015 as the private equity donor with privileged access to Ed Miliband, whose private equity firm, Nevsky Capital, had major holdings in key global health privatiser UnitedHealth. Taylor, who had donated large sums to Labour, first visited Ed Miliband in July 2013, just days after Miliband had delighted NHS campaigners by promising Labour would “reinstate the Secretary of State’s duty to provide comprehensive healthcare”. This unequivocal commitment was never heard of again from Miliband, who instead swung swiftly rightwards on health policy: in his next major NHS speech he endorsed pro-market policies like personal health budgets.

A major part of Corbyn’s appeal was that he promises a fresh start from this kind of elitist, corporate-influenced, revolving door politics. He has promised to put an end to the system where policy is shaped by, at best, ultra-establishment figures with well paid jobs within the current marketised system; and at worst, by lobbyists with interests in privatised healthcare. Corbyn promised instead that Labour would be a party of social movements and internal party democracy.

Why so many health campaigners wanted a fresh start from Corbyn

In his first two years of the last Labour government, Blair had been forced to pursue anti-market policies in the NHS by party conference. But in 2000 conference was neutered, and policy shifted sharply rightwards. Although conference has strongly voted against NHS privatisation when given a chance, such as in 2012, such votes were essentially ignored by the front bench, and in 2013 and 2014 the party machinery nobbled similar left-wing motions.

Instead, Labour’s health policy going into 2015 was heavily shaped by former SDP man Sir John Oldham (now working with private STP consultants GE Finnamore), who’d been hand-picked by the then Shadow Health Secretary Andy Burnham in 2013 to write Labour’s ‘Independent’ health policy commission report, the one which formed the basis of Labour’s manifesto policy. “No he wasn’t a Labour party member” and nor were any of the other policy Commission members, the Health Services Journal confirmed at the time. And of course ordinary Labour party members or NHS campaigners had no say in their appointment. Oldham’s report emphasised ‘self-care’ and the possibility of merging health with social care in a way that didn’t protect comprehensive, free healthcare.

No wonder then that Corbyn’s fresh start was widely appealing to both party members and NHS campaigners.

Straight-talking politics, or ‘crafting a narrative’?

Campaigners were disappointed to find little sign of a break with the past by Heidi Alexander. “I never saw Alexander show any evidence of enthusiasm for engaging with campaigners once she became shadow health spokesperson”, comments Dr John Lister, founding member of Keep Our NHS Public and umbrella group Health Campaigns Together.

Alexander was reluctant to criticise Stevens’ NHS plans, including the Sustainability and Transformation Plans. This was despite the fact that a high-level coalition of leading NHS campaigners and independent experts like Professor Allyson Pollock had managed to meet her and warn her strongly that these meant drastic cuts and more privatisation.

In an interview she gave to the Nuffield Trust in March this year, responding to a question about “transformation” – meaning services closing – she said this about STP cuts, “We can’t preserve the NHS in aspic…there’s a whole list of NHS buildings that’s supposedly surplus to requirements, so let’s use the NHS estate differently… let’s craft a story, a narrative, in which the public can believe and in which we can bring them along with us.”

The real problem that Alexander glosses over is that there’s simply no robust evidence behind large swathes of current Stevens- and Hunt-led NHS policy, notably the central narrative of ‘care in the community’. As even the Kings Fund acknowledges:

“it cannot be assumed that out of hospital alternatives are any cheaper. The direct costs of hospital care may in fact be lower unless significant costs can be shifted to carers or social care – neither of which are easy. In any case, switching to community settings just to save money risks increasing the burden on carers and adding to pressures on social care services, or disguising what are effectively poorer quality services.”

Faced by Labour health team silence – with the honourable exception of Justin Madders – on both privatisation and the fantasising behind the planned cuts NHS campaigners organised amongst themselves to bring these plans to public attention. They approached Corbyn and McDonnell, and found them willing to engage with those outside the usual ‘business as usual’ interests.

But for Alexander, that was somehow evidence that the new Labour leadership was “inept” – as was Corbyn and McDonnell visiting junior doctors’ picket lines and supporting the NHS Bill designed by experts and campaigners to end the NHS market and restore comprehensive healthcare.

All of these actions were cited by Alexander as the supposed final straw that prompted her to become the first person to resign from Corbyn’s shadow cabinet in the post-Brexit ‘coup’. She has since become Smith’s campaign manager – joining pharma and private healthcare lobbyist John Lehal who was appointed operational head of Smith’s campaign, and former lobbyist for pharma firm AstraZeneca at Finsbury, Will Tanner, who was appointed Smith’s head of communications.

And what of that campaign?

At times it has seemed as if there’s little to separate Corbyn and Smith on the NHS. Both have issued welcome pledges to address privatisation, reverse nurse training cuts, and increase spending on the NHS.

Corbyn has gone a little further in pledging to review current contracts and commit to no new PFI. His language on reversing privatisation is somewhat more credible than Owen Smith’s ‘100% publicly owned’ (soon subtly shifted to ‘if possible’).

Corbyn’s longstanding support for the NHS Reinstatement Bill, now being re-introduced by Labour MP Margaret Greenwood, has already won him many friends amongst NHS campaigners – including both Allyson Pollock and Lord Owen. His shadow health secretary Abbott has criticised the “wilful self-delusion” behind current NHS ‘efficiency’ plans in far stronger terms than her predecessor Alexander. Both Corbyn and Abbott have at last begun to talk about how privatisation / marketisation of healthcare isn’t just wrong – it’s expensive, and requires a vast bureaucracy.

Meanwhile Smith’s background as a Pfizer lobbyist (something he rather implausibly denies) has given Corbyn’s team an overdue opportunity to look at the elephant in the waiting room, big pharma.

But the real difference between Corbyn and the ‘business as usual’ crowd that seek to ‘reclaim’ Labour, is not as yet so much in policy detail, but in their attitude to democracy, and how they’ll develop that policy.

For too many politicians, NHS campaigners and independent experts have made nice decoration for election campaigns, but their actual knowledge of what things are like on the ground has been of little interest. Instead, unaccountable elites are allowed to dominate, in a way that increases the disconnect between voters and democracy. This is exactly the process going on with Sustainability and Transformation Plans.

It is the chance to change this which people feel is most valuable about Corbyn.

For the NHS, straight talking and honest politics are long overdue.

https://opendemocracy.net/ournhs/caroline-molloy/only-article-about-leadership-campaign-i-ll-write

Join the Vigil outside the Halifax Road entrance to Dewsbury Hospital 11am to 12 noon this Friday 16th September

To mark the downgrade of A&E services at Dewsbury Hospital and the removal of children’s inpatient and consultant led maternity services to Pinderfields we are holding a vigil for an hour outside the entrance on Halifax Road.

This action will sweep across the Pennines the next day, as campaigners demonstrate , to demand the reopening of Chorley A&E. Protests are taking place at WIGAN, BOLTON, CHORLEY, BLACKBURN, PRESTON, BLACKPOOL AND LANCASTER. . People who should have been taken to Chorley A&E now end up all across the region, at the hospitals mentioned above and anecdotally also in Salford, Manchester and Bury, thus putting pressure on them. In the same way, patients from North Kirklees will end up at Pinderfields or further afield, putting unnecessary  pressure on facilities there. Come and join us for an hour.  Take an early lunch break, or a late morning break.

We stand together

“The NHS will last as long as there are people willing to fight for it.”

Have you been redirected from Pinderfields A&E or maternity, to Dewsbury A&E or maternity, in the last 18 months? If so please “leave a reply”.  It will not be made public unless you request this.

The Trust says:-

“The changes will take place between September 16th and 19th. In summary:

 

New midwife led birth centres will open at Dewsbury and Pinderfields and the consultant labour ward will be centralised at Pinderfields which means all deliveries requiring consultant involvement (including Caesarians and epidural) will be at Pinderfields

Routine ante natal and post-natal care, including scans, will still be offered locally in the community and at all three of the Trust’s hospitals

There will be access to scans and assessment at Dewsbury for some women with complications in early pregnancy

A dedicated acute gynaecology and early pregnancy assessment service will be set up at Pinderfields

Paediatric inpatient services will be centralised at Pinderfields

The children’s assessment unit at Dewsbury will be open from 10am to 10 pm and children requiring hospital admission will need to go to Pinderfields (or to a more specialist children’s service)

Acute surgery will be centralised at Pinderfields

Most complex surgery and surgery for people who may need critical care support will be centralised at Pinderfields (except colorectal and  bariatric surgery which will transfer to Pinderfields when all critical care services are centralised in 2017)

More planned surgery will be provided at Dewsbury and Pontefract

Outpatient clinics will continue to be provided at all three hospitals

Changes to acute medicine and critical care services are due to take place in spring 2017.”

UPDATE 16th September 19:19

Many thanks to all who turned out especially MP Paula Sherriff who is a consistent supporter of keeping all services at Dewsbury Hospital and spoke about the issues here in Dewsbury, at the Opposition STP debate on Wednesday.

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And this is very important. What people with private health insurance and wallets full of cash have not realised is, that no private companies run A&E departments. So if they are in a road traffic accident, they are as vulnerable to death, having to travel 50 miles in an ambulance, as the rest of us.

The rain kept off, the Reporter Series and Look North photographers turned out and in the words of the song …

“We will not give up the fight, we have only started,

We have only started,

We have only start-ed”

Kirklees Councillors protect our NHS and stop the Slash Trash and Plunder

At 5pm on Weds 14th September,  Kirklees Councillors are attending a drop in session at Huddersfield Town Hall to hear about what is going on in secretive West Yorkshire “footprint” Sustainability and Transformation Plan Board meetings.

Councillors will get this briefing from Richard Parry, who is not only Chief Officer of North Kirklees Clinical Commissioning Group, but is also Director for Commissioning, Public Health and Adult Social Care at Kirklees Council.

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Richard Parry attends the secretive West Yorkshire “footprint” Sustainability and Transformation Plan Board  meetings – which seem to leave no public paper trail of agendas and minutes and which meet in private.

Of course the briefing drop-in will be whitewash, so please write to the Kirklees councillors for your ward  before this meeting, telling them of your worries about the STPs.

And if you want to lobby the STP drop in session, please turn up with  placards/banners at Huddersfield Town Hall at around 4.30pm on Weds 14th Sept.

Some of the worries about the STPs

44 area “footprint” “Sustainability and Transformation Plans”, being drawn up in conditions of secrecy imposed by NHS England, will accelerate NHS cuts and privatisation.

Savage NHS cuts – but no-one is saying where they will fall

The STPs must cut NHS services in line with the projected underfunding of the NHS in England by £22bn/year by 2020;  and by next financial year they must eliminate the collective NHS “deficit” – which is the result of six years of government underfunding.

This means West Yorkshire “footprint” STP must make savage NHS cuts on a West Yorkshire-wide basis. The secrecy of the process means we have no idea where these cuts will fall. And they are entirely uncalled for anyway.

As the sixth richest country in the world we can well afford to fund the NHS to an appropriate level to meet the people’s health care needs. The decision to underfund the NHS is entirely ideologically driven.

The NHS “market” regulator, NHS Improvement, has instructed NHS organisations to list services which could be axed or centralised, making “rapid progress” during the current financial year.

The West Yorkshire Sustainability and Transformation Plan finance template was due to be sent to NHS England on 31 August – but we very much doubt that Councillors have seen it. Please ask them.

Councillors did not see the “checkpoint” (work in progress) version of the West Yorkshire Footprint STP,  that the West Yorkshire STP leader Rob Webster sent to NHS England on 30th June.

Impossible STP conditions on  Calderdale & Huddersfield Hospitals Trust and Mid Yorkshire Hospitals Trust

We do know that as part of the Sustainability and Transformation Plan, NHS England and NHS Improvement have imposed a so-called “control total” on Calderdale & Huddersfield NHS Foundation Trust – ie the amount it can spend this financial year.  This “control total” requires the Trust to more than halve its planned £40.5m deficit this financial year, to £16.53m.

So what is Calderdale and Huddersfield Trust going to have to cut, to make this possible?

We do know that discussions about this and other Slash and Trash Plan conditions have been going on between NHS Improvement, NHS England and Calderdale & Huddersfield NHS Foundation Trust (CHFT), but we have no idea about the substance of these discussion. Please ask your ward Councillors to find out.

We do know that as a result of the STP, CHFT and Mid Yorkshire Hospital Trust have been told to:

  • merge Trust back office functions with other Trusts
  • merge pathology services – although it is completely unclear WHICH pathology services this covers – if it includes microbiology, this is a risk to patient safety
  • identify elective services that are largely locum-staffed and that could be merged across Trusts – apparently this could mean either other hospitals’ elective services could come to Mid Yorkshire Hospital Trust, or MYHT’s could go to other hospitals

In addition, because of the Slash and Trash Plan, MYHT has been told it can’t carry on putting patients before money as was it’s previous policy, so will have to refuse to employ expensive locums and agency nurses to reduce waiting times and safely staff wards. At the public meeting on 23 August in Dewsbury Town Hall the chair of MYHT Jules Preston said that a lot of services at Dewsbury Hospital were being dealt with by locums so patients are better going to Pinderfields! But if locums are going to be axed, where does that leave the promises that outpatients and other services will remain at Dewsbury hospital?  How can we trust what bosses are saying?  Please ask your councillor to put the question to Richard Parry.

We also have no idea how Calderdale and Huddersfield Foundation Trust is going to meet a condition of S&T funding, that it must have a recovery plan in place that shows when they will break even, within a “reasonable timeframe”. Because the Right Care Right Time Right Place pre-consultation business case shows CHFT in deficit for an unspecified time even beyond 2026, when the projected deficit will be £49.5m; and during the public consultation drop ins, no one from the Clinical Commissioning Groups or the hospitals Trust was able to say at what point beyond 2026 CHFT might break even.

What is all this going to mean for the proposed “Right Care Right Time Right Place” clinical model, that we have all wasted 14 weeks on a sham consultation about?

STPs require more NHS privatisation – wasting public money, damaging NHS care and penalising the poor and elderly

The so-called Sustainability and Transformation Plans – more realistically known as Slash and Trash Plans – aim to increase NHS privatisation.

This is a condition of the Sustainability and Transformation Funding agreed in the Autumn 2015 Comprehensive Spending Review, which agreed an extra £8bn NHS funding/year – cutting the projected NHS funding shortfall from £30bn/year to the current £22bn/year.

Dr Alan Brook, Chair of Calderdale CCG Governing Body, has said several times during the hospital cuts consultation that privatisation doesn’t matter as long as treatments remain free at the point of need. He is wrong. We have heard a rumour that Kirklees CCG has asked MYHT to recommend private providers to patients, to reduce waiting times, a practice we know from experience is already embedded with some consultants. That revenue is then lost to the publicly run provider, which is having it’s ability to run services deliberately curtailed! Where is patient choice when you HAVE to choose a private provider? It has been lost. Are the risks and downsides of choosing a private provider. explained to patients? *

It is a massive waste of precious NHS money, with the costs of managing the NHS “market” estimated at somewhere between £4.5 -£30 bn/year. No one even knows!

NHS privatisation also runs down NHS care and penalises the poor and elderly.

This is an outlaw process – STPs have no statutory basis and no formal, accountable governance process

West Yorkshire and North Harrogate is STP Footprint 5. Like the other STP footprints, it  has no statutory basis and the West Yorkshire STP is being drawn up by organisations operating without any formal governance process.

The secretive preparation of Sustainability and Transformation Plans, which have only come to light in the last few weeks, is an appalling abuse of our democratic rights. Local authorities’ Health and Wellbeing Boards, Clinical Commissioning Groups, NHS England and NHS Improvement all play a role in the development and implementation of Sustainability and Transformation Plans – but none of them are telling the public what is going on.

Strangely, for such a momentous plan – which would amount to the last nail in the NHS Coffin because of the cuts and further NHS privatisation it will require – the Sustainability and Transformation Plan is not listed in Kirklees Council’s Key Decisions and reports.

Find your councillors here http://democracy.kirklees.gov.uk/mgFindMember.aspx

NOTES

*https://chpi.org.uk/wp-content/uploads/2014/08/CHPI-PatientSafety-Aug2014.pdf

*https://chpi.org.uk/wp-content/uploads/2015/12/CHPI-PatientSafety-Dec15.pdf

What is an Integrated Care Organisation? Stalybridge public meeting on 22 September will find out!

The Public Meeting organised by Tameside Keep Our NHS Public on Thursday 22 September at Stalybridge Civic Hall, in the District Assembly Room, starts at 18.30, with doors opening at 18.15. It will end at 20.00.

This meeting about Tameside Integrated Care Organisation is very useful for Kirklees and Calderdale  people, because Tameside NHS bosses have gone ahead and done what Calderdale and Kirklees Clinical Commissioning Groups and Health & Wellbeing Boards are still talking about doing – imposing a new form of public/private partnership on our NHS; and this time, not for new buildings, but for NHS treatments and services.

Tameside has now become an Integrated Care Organisation, with little explanation to or involvement of the public. “Seismic changes” are underway in Health and in Social Care, which will affect both patients and workers. It is important that local residents have the opportunity to hear about this and have their say. They are also entitled to hear the views of those who work in these vital services.

Speakers will include Milton Peña, former Consultant Orthopaedic Surgeon at Tameside Hospital, now a campaigner for the NHS; a Junior Doctor in psychiatry; a Social Worker with adults, and Paul Dunn, North West Operational Manager for the Royal College of Nursing.

If you’re planning to go please RSVP to: Konp.tameside@gmail.com

Integrated Care Organisations – another name for Accountable Care Organisations

Here’s info about Integrated Care Organisations from Monitor (since changed into NHS Improvement) , Ealing and Harrow Integrated Care Organisation and from the Kings Fund – which shows that Integrated Care Organisations are just another name for Accountable Care Organisations.

In American, an Accountable Care Organisation – aka a Health Maintenance Organisation – is a form of health company that provides managed care ( ie care that follows set protocols and pathways on the basis of a capitated budget (ie a fixed cost amount for each person in the area served by the ACO) for a private health insurance company.

Health Maintenance Organisations (HMOs) were promoted by President Nixon through the HMO Act of 1973, before he resigned in 1974 to escape impeachment for obstruction of justice, abuse of power, and contempt of Congress.  John Ehrlichman – later imprisoned for his role in the Watergate scandal – persuaded Nixon that HMOs were the future for American healthcare on the grounds that:

“All the incentives are toward less medical care, because the less care they give them, the more money they make.”

Jeremy Hunt, the Secretary of State for Health, advocates that the NHS turns itself into  Accountable Care Organisations or systems based either on the American Kaiser Permanente system or the Spanish Alzira/Valencia model.  The Alzira ACO model is a private/public partnership – like PFI but for NHS services as well as buildings. The Northumbria ACO was set up via a Special Purpose Vehicle – the same financial arrangement as for  NHS hospital PFI schemes.

ACOs/Integrated Care Organisations are clearly a route to the further NHS privatisation that is required as a condition of the Sustainability and Transformation Plans.

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Urgent letter to send to your MP; Defend the NHS in the Opposition Debate, Wednesday 14th September

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Westminster

Letter to your MP: speak out in the Weds 14th September Opposition Debate on NHS cuts.

Here is a template letter to send your MP.

You can copy the template and fill in the blanks and change it as you see fit.

Or download it as a .doc or .txt file here

Urgent letter to send your MP: Defend the NHS in the Weds 14th September Opposition Debate

You can find your MP’s name and contact details here:

http://www.parliament.uk/mps-lords-and-offices/mps/

Dear [insert your MP’s name]

On Wednesday 14th September,  there will be an opposition debate on NHS cuts in the House of Commons. I am asking you, as my MP, to attend the debate and to demand that Jeremy Hunt:

  • stops the STPs,

  • protects and reinstates full acute and emergency hospital services at district general hospitals,

  • protects other NHS services from cuts and privatisation.

These measures are necessary in order to make sure that the NHS is restored as a

comprehensive health service that is equally available to all who have clinical needs for it.

44 area “footprint” “Sustainability and Transformation Plans”, being drawn up in conditions of secrecy imposed by NHS England, will accelerate NHS cuts and privatisation.

NHS Improvement has instructed NHS organisations to list services which could be axed or centralised, making “rapid progress” during the current financial year.

The secretive preparation of Sustainability and Transformation Plans, which have only come to light in the last few weeks, is an appalling abuse of our democratic rights and is being met with protests at local authorities’ Health and Wellbeing Boards, Clinical Commissioning Group meetings and the offices of NHS England – all organisations with a role in the development and implementation of Sustainability and Transformation Plans.

In our constituency, there are public campaigns to keep services at Dewsbury hospital, support the Junior Doctors, stop the STPs and prevent Virgin Care getting the Children’ Services Contract, (soon to be launched).

This needs your support. Please show it, by telling Jeremy Hunt to stop his NHS cuts and privatisation policies, that are undermining, fragmenting and dismantling the NHS in our area.

Despite protests, campaigns and media coverage, many people still do not know about these cuts and privatisations and the STPs. By speaking out against them in the Opposition Day debate, you will help to increase the public’s awareness of them.

We urgently need to you to help get the information out there to the general public in this way – as well as making sure Jeremy Hunt knows the damage his policies are causing.

Only your effective opposition in the House of Commons, combined with mass public opposition, can stop and reverse the cuts and privatisations, stop the STPs and restore the NHS.

I call on you as my MP to commit to urgently support these local campaigns and protests in our constituency, and to oppose the STPs and NHS cuts and privatisation at every opportunity in the Houses of Parliament – including during the Opposition debate on

Wednesday 14th September.

The worst Secretary of State for Health the country’s ever had is slashing the NHS to pieces and privatising it at an accelerating pace. Secretive Sustainability and Transformation Plans (which campaigners call Slash, Trash and Plunder, because that’s   will do to the NHS), will mean the end of the NHS as a comprehensive service that is equally available to everyone who needs it.

One of the latest NHS cuts is the sudden restriction of A&E opening hours at Grantham Hospital – announced on the 11th August and carried out on the 17th August. https://www.facebook.com/groups/1585988212

Grantham A&E is now only open from 9am to 6.30pm. In the evening and overnight, Grantham people who need emergency care have to travel 45 minutes to Lincoln A&E or 1 and a half hours to Pilgrim Hospital in Boston.

Extra distance to A &E is association with increased emergency patients’ death rates, as reliable studies have shown. This is unsafe and unfair.

This is just the latest example of ruthless cuts to NHS services that threaten the safety and health of people in need of health care. That is all of us, at one time or another.

There are well over 50 non-party/cross-party groups campaigning across England to stop and reverse NHS cuts and privatisation and to stop the STPs.

The Opposition Day debate on the 14th September is your chance to support your constituents in the House of Commons and bring the fight to save our NHS right where it belongs – to the worst Secretary of State in the history of the NHS.

Signed:

[Give your name and postal address, MPs will only take notice of correspondence from

their own constituents]

The future health of people in England, needs YOU to do summat now!

We stand together

 

Reproduced from a blog By National Health Action’s Dr Walker.

Watching the battle lines emerging in the press reporting of the new mass cuts regime currently being implemented across the NHS is pretty instructive. On one side you have the government and their appointed spokespeople, scrambling to assuage a newly anxious population with the soothing language of consolidation, reconfiguration, efficiency, and modernisation. They are, of course, gambling on being able to sustain public obliviousness to the fact that these words are synonyms for service cuts, lost beds and staff lay-offs. On the other side, a variety of campaigning groups, doctors and politicians using an array of evidence to carefully unpack these reconfiguration fantasies.

The sheer scale and imminence of cuts is, even for seasoned austerity-spotters, truly shocking to behold. What is interesting now is the extent to which those who are pushing for, and making possible, these cuts have critically departed from reality. We hear that in Dorset, the new STP plan suggests that a ‘reduction in the number of sites’ would lead to a better provision of services ‘for more hours of the day and days of the week’.

In Hampshire and Isle of Wight, commissioners are planning to make general practice more sustainable by cutting GP workload by almost a third, while also significantly reducing patients’ face-to-face contact with primary care.

Stephen Dalton, chief executive of the NHS Confederation said, “These local plans are being made when funding is very tight but they are not about cuts, they are about modernising services to match people’s changing care needs.” I suppose if people’s changing care needs included a need to die of entirely preventable illnesses then he would be right. But it is not.

No amount of PR window dressing and STP gobbledegook will ever convince anyone that removing beds, services, A&E units and GP surgeries is going to lead to better patient care. Indeed the way in which STP plans are wrapping the extraordinary shrinking of our NHS in the language of better patient care has now stretched incredulity to a truly insulting level.

Thus far, those who resist these cuts publicly have made salient points about poor public consultation and lack of democratic accountability, about GPs being excluded from the STP planning process, about how the delivery of integrated care is incompatible with mass service reduction and how poor community provision means it is impossible to transfer acute services to the community.

Huge numbers of people unable to see their GP means a massive increase in patient risk. People are going to die as a result.

For example, when Leicester, Leicestershire and Rutland region, reduce the number of acute hospitals from three to two people are going to die as a result of this. Or when in the Black Country region of the West Midlands the number of acute units are cut from five to four and when one of two district general hospitals closes people are going to die. You’ll find the same wherever you live.

The STPs are going to kill people.

Dalton is selling this as modernisation and improvement: it is not, it is the end of the NHS as a comprehensive, universal and accessible service. Most people out there have not been seduced or befuddled by the corporatisation of health discourse that has been designed to obscure mass public service vandalism. When NHS England, the Department of Health, The NHS Confederation and the poor sods charged with spinning STP straw into gold defend against accusation of cuts with their consolidating reconfigurations they remind me of playing hide and seek with my young son who thinks I can’t see him because he’s covered his hands with his eyes. The health mandarins can cover their eyes if they wish but we can still see them.

So where and how do we hit back and resist against this institutional policy barbarity? I have no doubt that many NHA members out there are already actively campaigning against STP but if not and you want to get involved then here are eight ways to campaign

1. sign this national petition again and again and again (share it again that is, only sign it once)
2. spread this fantastic blog far and wide letting people know the real figures behind this sorry mess
3. join a local NHS campaigning group, whether that be NHA, 999 Call for the NHS, Keep Our NHS Public or other. If one doesn’t exist in your area then get one moving with a few friends.
4. use the recent articles in the national press to push for local public consultations and work with friends and colleagues to drum up support to go to these
5. hold local public meetings once the detailed STP plans have been released in your area and the plans for A&E closures and GP closures are announced. Use these public events to inform people and as a base to develop further campaigning
6. it’s a thankless task sometimes but lobby local councillors to stand up in your interests. Let local newspapers know which of them are prepared to stand with the public interest against the STP cuts in their area
7. use the recent articles in the national press to push for local newspaper health editors to report on STP developments and to attend consultation events
8. start a local petition against the closures and coordinate with other groups across your STP area.

These are just a few ideas, there are of course many more. But if ever people were thinking of getting more actively involved in the fight to save the NHS then this is the time.

“The rule is jam tomorrow and jam yesterday – but never jam today”

‘The rule is, jam to-morrow and jam yesterday – but never jam to-day’

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Paula Sherriff MP chaired the meeting.

Public Meeting about Dewsbury Hospital Service cuts due mid September

The public meeting on 23 August 2016 at Dewsbury Town Hall was about the upcoming changes to Dewsbury Hospital services, which will kick in over the weekend of 17 September.

Consultant-led maternity services will no longer be available and will be replaced by a midwife-led birthing unit. Mothers expecting complicated births are due to be sent to Pinderfields. There will be reduced opening hours at the Dewsbury’s children’s assessment unit, from 10am-8pm.

North Kirklees Support the NHS have dubbed the scheme a “recipe for disaster” and say it is ludicrous to have a midwife-led unit so far away from the consultant-led and emergency surgery facilities. They point out that the difference between a low-risk birth and a high-risk birth can be as little as six minutes.

At the meeting, Mid Yorkshire Hospital Trust said that they are working with unprecedented levels of demand (i.e. need) for its services.

Why?

Care Closer to Home is Jam Tomorrow

In 2013, at the “Meeting the Challenge”http://www.meetingthechallenge.co.uk/home/ Consultation sign off – which everyone thought was unfair and without a shred of ‘independence’ anyway – North Kirklees Clinical Commissioning Group said that no changes to Dewsbury hospital would take place until Care Closer to Home was up and running and able to keep people out of hospital.

Even further back in time, the Grasping the Nettle reconfiguration of 2007 promised more Care Closer to Home. That didn’t materialise so why should anyone have confidence that there will be ‘improvement’.

In the “Through the Looking Glass” world of North Kirklees CCG, Care Closer to Home has turned out to be jam tomorrow:

‘The rule is, jam to-morrow and jam yesterday – but never jam to-day.’

‘It MUST come sometimes to “jam to-day,”‘ Alice objected.

‘No, it can’t,’ said the Queen. ‘It’s jam every OTHER day: to-day isn’t any OTHER day, you know.’

How the CCG thinks that withdrawing money from MYHT for vanity projects like a renal specialist across the Healds Road in the GP surgery opposite the hospital, or a skin clinic at another GP surgery in the countryside somewhere is Care Closer to Home, I don’t know.

It all depends where you live. People with poorly children may have chosen to live near Dewsbury hospital to be within easy reach for trips to A&E and visiting. They will now need to go to Pinderfields if their child needs an inpatient stay. Care further from home.The CCG said that people with children who have ‘direct access’ to hospital services will get a communication soon, about the changes and advice about what to do.

Time and again at the 23rd August public meeting, the Mid Yorks Hospital Trust and North Kirklees CCG used the 2013 “Meeting the Challenge” sign off decision to legitimise the upcoming maternity and children’s service cuts and changes at Dewsbury hospital, but the audience was not convinced, because experience trumps rhetoric every time.

This bodes ominously for the proposed changes being hatched in secret by the architects of the West Yorkshire Sustainablilty and Transformation Plan.

Health and Social Care Act 2012 is source of problem

When we used to have a National Health Service, finance allocation would be distributed according to need and since deprived communities with low incomes and sometimes contaminated environments had more health need they would be allocated more resources.

Now this does not happen, because the Health and Social Care Act 2012 replaced the National Health Service.

The risk register compiled by civil servants ahead of the Act was illegally suppressed by the coalition government. When it was leaked last year, professionals could see that the predicted risks were coming to pass: reduced services, fragmented pathways and blind decision making.

North Kirklees CCG said it has to keep within budget. And a Mid Yorks Hospital Trust Board meeting had to review the policy to retain safe staffing levels by increasing spending on agency staff, otherwise the Trust would be subject to a ‘failure regime’. The Francis Report after the Stafford Hospital scandal counts for nothing with the regulators now, it seems.

We are 6 years into massive underfunding of the NHS

David Nicholson and Simon Stevens have both used their time as NHS England CEOs to implement successive governments’ public spending cuts, that have led to a shortfall in NHS funding of at least £17.5bn/year, averaged over the 10 years between 2010 and 2020.  
The NHS needs an increase of 4% per year, just to keep pace with population growth, increased complexity of treatments and price inflation in essential medical supplies - but has not been getting it. 
Between 2010 and 2015, the NHS needed a funding increase of £20bn/year but it got £7bn/year - suffering a total funding shortfall over that period of £65bn  (or £13bn/year).
Between 2015 and 2020, the NHS needs a funding increase of £30bn/year, but it is going to get an extra £8bn/year.  Over this period, the NHS will suffer a total funding shortfall of £110bn, (or £22bn/year).
As a result of these so-called “efficiency cuts”, the NHS is underfunded - actually spending less than it should on healthcare. That's quite the opposite of an 'overspend'! But even an injection of cash - although necessary - will not fix the ills of the health service.  
Through the NHS Sustainability and Transformation Plans, HM Government is conducting an experiment on the health of the English people on an unprecedented scale.  North Kirklees CCG’s move to 'integrated care' is an import from the US. Accountable Care Organisations, set up with a financial product called 'Special Purpose Vehicle' like those set up for the PFI hospital deals, are the next big thing to replace failing Trusts or CCGs and are themselves a failed US import. 
Time to say STOP!

https://www.opendemocracy.net/ournhs/stewart-player/accountable-care-american-import-thats-last-thing-englands-nhs-needs

Do summat: Come to the Public Meeting: Dewsbury Town Hall: 23 August 2016: 7:30pm

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Public Meeting about the changes to Dewsbury District Hospital from Mid September 2016, Dewsbury Town Hall: Tuesday 23 August 2016: 7:30pm

Paula Sherriff MP, in the chair

Invited:
Mid Yorkshire Hospital Trust
North Kirklees Clinical Commissioning Group
Healthwatch (now unable to attend)

Services at Dewsbury hospital have changed following the Meeting the Challenge Consultation plans which were approved by government, in 2013.

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No amount of shouting will change that now!

http://www.meetingthechallenge.co.uk/home/

The next changes are due to take place in mid September 2016, with a further set of changes in March 2017.

The residents of North Kirklees were promised that no changes would take place to the Dewsbury Hospital, without the Care Closer to Home provision being in place. But how do we know what that is and how to access it? How do we know if it is working?

Are you happy with the provision? Is it working for you?

Come to hold the decision makers to account.

If you would like to participate but can not be there in person, please tell us you have a question. You can do this by leaving a message after clicking on the comments button on the website www.northkirkleesnhssupportgroup.org.uk and we will get back to you in private.

Are you clear about what service to use for your illness or complaint? Is your GP your first port of call? Is the 111 service working for you?  Do you know how complain?

The West Yorkshire region in general has been told to get together to cut the deficits in the Trusts by next year. It has to come up with local and a regional plan. (STP) West Yorkshire is number 5.

https://www.england.nhs.uk/wp-content/uploads/2016/02/stp-footprints-march-2016.pdf

Why? The money given to the health service  is an arbitrary sum.  The Trusts have run up deficits largely by treating people they have not been paid for and using expensive temporary staff  to fulfil their desire to keep waiting lists down.  No more will they want to do that! Waiting lists are bound to go up. NHS England has said it will assume control and possibly establish some sort of US style Accountable Care Organisation instead, if they do not save money. ‘Accountable’ means for the money by the way, not patient health.  Will the STP fund be enough?

https://chpi.org.uk/wp/wp-content/uploads/2016/07/Sustainability-and-Transformation-Fund-.pdf

About us

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We are a coalition of ‘Defend the NHS’ Campaign groups, working to highlight the policy and processes behind the changes to hospital provision in Dewsbury.  These sorts of changes are  also happening all around the country. The photo shows some of us at a recent “Hands Round Dewsbury Hospital” event. We are building on the success of the Save Our Local Hospital Services group (SOLHS).  SOLHS alerted the Joint Kirklees and Wakefield Health Overview and Scrutiny Committee,(JHOSC) to the dangers of the changes proposed to Dewsbury Hospital.

Because of issues highlighted by the SOLHS campaign, the JHOSC decided that the changes were ‘not in the interests of the local population’ and referred the plan to the Secretary of State for Health,  Jeremy Hunt. He gave their report to the inappropriately named Independent Reconfiguration Panel who decided that it was government policy and the Clinical Commissioning Groups should go ahead and reconfigure the services.

No sooner had this decision been taken, than the news in the Daily Mail highlighted the risks to patients at the neighbouring hospital, when Newark A&E was closed.

http://www.dailymail.co.uk/news/article-2323141/Shocking-proof-Accident-Emergency-closures-cost-lives-Death-rate-jumps-THIRD-department-closes.html

So we believe local patients are at risk due to longer ambulance travel time and the people of Wakefield will also be at risk because people will not be able to be admitted to hospital in Dewsbury, but have to be transferred to Pinderfields, putting extra pressure of numbers, on to the facilities and staff.  The Chair of the North Kirklees Clinical Commissioning Group stresses that the A&E at Dewsbury is not closing, but from September 2016 the only Acute, that is, emergency cases it will be admitting, are Acute Medical cases such as people with pneumonia and serious life threatening asthma attacks. The plan is to eventually admit these patients to Pinderfields as well, when the conditions are right!