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

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.


  • 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


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


  • 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


  • 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:

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.

Go, or No Go for the next round of changes to Dewsbury Hospital due to begin on 4th September

Today, 3 August 2017, the North Kirklees Clinical Commissioning Group, met with Wakefield Clinical Commissioning Group, to accept or reject the assurances of Mid Yorkshire Hospital Trust (MYHT) and Yorkshire Ambulance Service (YAS), that the centralisation of Critical Care at Pinderfields Hospital in Wakefield addressed all the concerns raised by something called the Star Chamber, which as we understand it, is a group of doctors looking at safety for patients amongst service change at various Hospital Trusts.

After looking at the papers for the meeting, this blog asked some questions. The general questions for which time should have been allocated at the start, were not answered. The comment was that they were questions about the STP and we don’t know the answers. These will be listed a the end of the account.

Questions about Service Changes at Dewsbury Hospital.


Centralising Critical Care in Pinderfields

Does this mean there will be no high Dependency Beds in Dewsbury?


There will be no High Dependency beds in Dewsbury.


If someone ‘goes down’ ie gets worse, while in the ambulatory care ward…where will they go for stabilisation and help?


There are protocols which are followed when something like this is happening. There are resuscitation and CRASH teams  on the Dewsbury site. There will be an anaesthetist at Dewsbury for 24 hours 7 days a week.


What is the priority for ambulances for inter hospital transfer? Has the implication for the ambulance service to move patients, been satisfactorily addressed?


Yorkshire Ambulance Service has been part of the discussions about the service changes at Dewsbury hospital and also in the Mid Yorkshire region where it is contracted by 23 CCGs. Other hospitals are also undergoing service changes and the two CCGs need to to be sure that a change in an area away from here, does not have a knock on impact and compromise the service when a patient needs it here. They (YAS) are coming up with a novel approach,  a new category which needs a response, but there are 2 issues here, response capacity  and resources.

Checks and balances will be at work and some of the changes will reduce pressure on the Ambulance Service. North Kirklees CCG and Wakefield CCG want something in writing to confirm that YAS is ready, with no commitment from the CCGs to provide more resources.

North Kirklees CCG Governing Body ‘Chair’ Dr David Kelly, stressed that they can not proceed with out this extra assurance in writing and that if it is not forthcoming there will need to be another ‘extraordinary Governing Body meeting to discuss the ‘risks’ associated with not going ahead with the changes. (This is because winter pressures will mean extra capacity is needed in the hospital while it is still trying to manage critical care.) Since all YAS’s services are funded by the 23 CCGs it is not easy to separate out one hospital, but they would need to assure themselves about resources.

The North Kirklees CCG Chair said “The two issues are resources and assurance that YAS can deliver the service. If we can’t get it, we can’t push the button.”

In that case the changes would have to wait until May 2018, with all the risks associated with that. The Chief Operating Officer for both CCGs said ” We  constantly juggle resources with patient safety issues.”


Are there any instances of difficulties in getting people repatriated to the non critical hospital due to lack of ambulances?

Question not answered.


Are there any instances of difficulties getting patients into the Critical Care Centre due to lack of ambulances? Eg women in labour.

Question not answered


What is a definition of ‘Frail Elderly?’


Frailty is about  a vulnerable person with multifaceted and a number of conditions, not always age related, who deteriorate quickly.


What is the Frail Elderly pathway?

This includes the new Clinical Decision Unit (CDU) and ambulatory care. It is so that the Frail Elderly don’t wait in A&E and don’t stay in a bed too long. There is a National Process for ‘quality and safety’ which will be followed.


The Chief Operating Officer for the 2 CCGs Pat Keane,  went on to say that the extra service changes were mitigated against the Equality Impact Assessment.

The Recommendation from the meeting was that “We proceed subject to assurance by YAS but that this assurance will not commit us to funding.” There was more to the recommendation but not all of it was read out.

The wider  MEETING the CHALLENGE programme.

The Chief Operating Officer for both CCGs said that the CCGs had engaged “Good Governances” because the Meeting the Challenge has yet to complete and the Star Chamber’s metrics did not take into account the promises made to patients. There has been a lot of activity and “Good Governances” had begun to take interviews from parties involved although the Chair of North Kirklees CCG said he had not been approached.  One of the Governing Body members from Wakefield CCG said that it would be good if people can know how their conversation feeds into the report. It was also said that patients and the public will be involved in this Good Governances initiative. If interested, get in touch with your local CCG and request to be involved.

QUESTIONS UNANSWERED: look for the answers in the papers for North Kirklees CCG  Governing Body; 30 August 2017


City & Hackney CCG are reluctant to hand over responsibility for local decisions about NHS organisation and funding, to the East London Health and Care Partnership, based on advice from their lawyers as to the legality of ELHCP’s proposed arrangements.

Have North Kirklees CCG had legal advice about the West Yorkshire STP decision making process?


City & Hackney CCG are reluctant to hand over responsibility for local decisions about NHS organisation and funding, to the East London Health and Care Partnership, based on advice from their lawyers as to the legality of ELHCP’s proposed arrangements.

Have Wakefield CCG had legal advice about the West Yorkshire STP decision making process?


Are North Kirklees CCG Governing Body going to hand over responsibility for local decisions about NHS organisation and funding to the West Yorkshire STP?


In the light of the ongoing issues with the Care Closer to Home providers, this handing over would not seem wise since the local CCG has to carry the risk/responsibility for commissioning and subsequent problems. Has the NKCCG got a strategy for this eventuality ie problems and what is it?

Are Calderdale Councillors scared of the Government and NHS Bodies?


Huddersfield TUC, campaign groups and the public, begin to assemble outside Huddersfield Town Hall.

On 21 July 2017 Calderdale and Kirklees Joint Scrutiny Committee met to discuss whether the proposals they had made to the Greater Huddersfield CCG, Calderdale CCG and Calderdale and Huddersfield Foundation Trust (CHFT), about their  plans to reconfigure the Hospital Service in the area had been met. If they had not been met then the Scrutiny Committee had the powers to refer the proposals to the Secretary of State for Health. Campaign Groups Hands off HRI, Let’s Save HRI, Friends of HRI, Huddersfield Keep Our NHS Public and Calderdale and Kirklees 999 Call for the NHS, were in attendance. All the campaign groups in their deputations called for the proposals to be referred.

Joint Health Scrutiny Committee – please refer the hospitals and community care reconfiguration to the Secretary of State

Here is the deputation from CK999.


I’m speaking as chair of Calderdale and Kirklees 999 Call for the NHS.

We’ve carefully read the CCGs’ and Trust’s reports to this meeting and it’s clear that they haven’t satisfied the Committee’s recommendations – which were designed to make sure that the proposals would meet the health needs of the population.

So we’re extremely concerned that the NHS organisation’s failure to satisfy the recommendations means that these proposals won’t meet the population’s health needs.

We therefore ask you to refer the proposals to the Secretary of State for Health.

The CCGs and CHFT have had months to do the recommended work to make their proposals safer, but they haven’t got round to it.

The Trust’s failure to sign off and publish the Full Business Case makes it impossible to assess the finances and what the costs of a second PFI debt would be.

The CCGs say they will only support the Full Business Case – once they’ve reviewed it – if it fits in with the Sustainability and Transformation Partnership’s cost cutting plans.

More important than money – the CCGs have failed to come up with a coherent plan for providing enough Care Closer to Home capacity to make up for the 105 lost hospital beds.

They plan for a 3.5%/year reduction in A&E attendances by patients with long term illnesses, but the NHS Transformation Unit  are very doubtful that they could achieve this when they’ve not managed anything like it so far.

And the CCGs haven’t yet done the community modelling work to figure out how this will be possible.

As a result, proposed measures to make sure 111 sends patients to the right places will have to wait until the CCGs have clarified what the right places are.

And the Clinical Senate are still unable to confirm that the “plans” will provide the required standard of care, because the CCGs won’t have the information the Senate needs until the implementation planning.

Staffing is vital for patient safety – but CHFT plans to cut 479 staff over the next 10 years.

It says this will be possible because there will be “clinical networks” and centralised hospital services for very seriously ill patients.  In other words – such patients will go to Leeds or Pinderfields and our hospitals here will shrink.

The Trust’s workforce strategy indicates a 3.4% increase in Community Nursing staff, which is totally inadequate for the task in hand; and although there’s no pool of trained staff to recruit from, it doesn’t accept any responsibility for ensuring that training is available locally.

The CCGs have refused to say what their Primary Care strategy is, so there’s no idea if or how they plan to restore the numbers of GPs  – who will be responsible for more acutely ill patients.

The NHS organisations have recklessly disregarded the JHSC’s recommendations. Their proposals do not meet the public’s health needs and the JHSC’s clear duty is to refer them to the Secretary of State.

You can see the meeting in full here. (copy and paste the link into your browser)
Or read a comprehensive account here:-
The issue is important to Keep All Services at Dewsbury Hospital because when the reconfiguration to Dewsbury District Hospital was at the Consultation Stage in 2013, acceptance was undertaken on the premise that there was a fully functioning A&E in Huddersfield. These plans remove that certainty and replace HRI with what sounds like a GP surgery with a 64 bed Urgent Care Centre for minor injuries plus elective day case and elective short stay cases, with no intensive care or high dependency beds. The knock on effect of more ‘blue light’ cases going to Halifax, Pinderfields and Leeds will increase the already overcrowded facilities there.
Save Dewsbury Hospital Services banner before the meeting.
Paula Sherriff MP for Dewsbury,  Denby Dale Mirfield and Kirkburton gave a deputation statement reminding Councillors of this fact. The Chair of the Joint Scrutiny Committee said she was also on the Scrutiny Committee for that Mid Yorkshire Hospital Trust reconfiguration, which incidentally has seen the difficulties with the Care Closer to Home provision and the Mid Yorkshire Hospital Trust has moved to put all the planned changes at Dewsbury, in the slow lane. See more here:-
 The Calderdale and Kirklees Joint Scrutiny Committee adjourned after the deputations, and consideration of the report involving  questions to the NHS bodies, on their proposals. It is interesting that the Chair of Greater Huddersfield CCG was not present, only Carol McKenna, the Chief Officer. Finance Officers were present from Calderdale CCG but neither the Chair or Chief Officer attended. CHFT was represented by Owen Williams the CEO.
It was following the adjournment that the 2 new proposals drafted by the Scrutiny Committee on the consultation, were read out and Councillors asked to vote on them.
It was then that the 3 Calderdale Councillors, gave their shocking opinion that if they were to refer these proposals to the Secretary of State, then they may get something worse, so they would not vote to refer.
Nevertheless, fortunately other Councillors used their common sense and the proposal to refer was carried by 5 votes to 3.
A retired Consultant joins the members of the public.
This blog is considering whether to accept that the fear of Government and NHS bodies by the Calderdale  Councillors, is evidence of an increasing rise in Private Government in the NHS, where ‘capital’ is seen to control working lives, such as GPs being asked to refrain from prescribing
  •       paracetamol,
  • antihistamines,
  • gluten-free foods
  • sunscreens for skin protection from UV radiation
  • soya and thickened infant formulas
  • infant formula for lactose intolerance
  • cream for unwanted facial hair and other products that have a predominantly cosmetic action
  • emollient (moisturiser) for minor skin conditions
  • camouflage products e.g. for port wine stain birthmarks
  • multivitamins, where no specific deficiency has been identified

Hospital staff being made to work shifts of 12 hours and out of social duty, choosing to  forego  breaks, due to pressure of patients, would be another indicator.  What would happen if they worked to rule?

See more info on that here:-

Theresa May

Halifax Road main entrance as it used to look. It has been changed in the initiative to erect motivational adverts in all Mid Yorks Hospitals.

Yesterday, 28 June 2017, MP Paula Sherriff asked a question about Dewsbury Hospital and Huddersfield Royal Infirmary, at Prime Ministers Question Time.

Ms Sherriff asked: “She stated, and I quote, ‘people were scaremongering’.

“Can she use this opportunity today to reassure my constituents that all services will be retained at both hospitals, including a full A&E provision?”


The Prime Minister responded: “Yes I was asked about Dewsbury A&E and I can confirm that Dewsbury A&E is not closing. The service will be open 24 hours a day, seven days a week and patients will see no change to their services.”

In fact the A&E in Dewsbury is already downgraded, so there will be no change to provision and it will remain so. It is NOT  FULL A&E provision although, yes it is open 24 hours a day and you can go there seven days a week.

Full A&E provision in the traditionally accepted form,  involves the availability of a High Dependency Unit, Intensive Care, a complete set of consultants from all specialities and general surgeons ready to deal with emergency injuries. These facilities are no longer available at Dewsbury District Hospital.  The new name for a ‘proper’ A&E is Emergency Centre.  Dewsbury is not an Emergency Centre.

Young children who are taken to Dewsbury between 8pm at night and 10am the following morning are sent to Pinderfields, even for minor cuts to the face and even if no x-rays or scans are deemed necessary. Children needing overnight stays for monitoring or further tests need to be taken to Pinderfields.

People suffering from a stroke should go to Pinderfields.

Emergency childbirth cases go to Pinderfields. Dewsbury’s Birth Centre can not administer epidural pain relief, nor are there special cots for babies who are poorly when they are born, available.

Mrs May is risking people’s lives if she is willing to mislead them in the way she has and they turn up at Dewsbury, when they should be at Pinderfields. Dewsbury has 4 resuscitation beds for adults and one for a child. It has 4 ‘enhanced care’ beds, for elective surgery patients only. It is not closed, but it is not a full A&E in the traditional sense.  “The rooms behind the A&E have changed” said a MYHT Board member recently.  There are 2 wards over and above those specified in the Full Business Case at the Meeting the Challenge reorganisation and a number of elective colo-rectal surgery operations, due to lack of capacity ie not enough room, at Pinderfields.

Who knows what cuts are down the pipeline in the West Yorkshire Sustainability and Transformation Plan arrangements? We will be asking all our MPs to keep their eye on the ball with that one.

Today (29th June 2017) Tracey Brabin MP spoke in the House about the fact that her some of her constituents were being made to wait for operations for 6 months and up to a year, if they smoked or if they were classed as obese. This move has been brought in by the North Kirklees Cinical Commissioning Group, to ‘manage’ demand and is not clinician led as Andrea Leadsome said it was, rather it is ‘manager led.’ While it is hoped that clinicians are able to over rule the managers if a cancer needs to be removed, for example, it is the beginning of ‘managed care,’ a regime used in the US by insurance companies, to restrict treatment and therefore maximise profit. While the NHS as yet is not looking for a profit as a whole, individual bits of it, those with for-profit providers, are.  Paula Sherriff MP also reiterated her question about Dewsbury A&E. Andrea Leadsome said she did not understand the question and invited Paula Sherriff MP to write to her about it.

As for the denying operations to some classes of patients, it is a very slippery road to be going down. Why should someone who has been sexually abused as a child, be punished again in adulthood and have treatment denied?  Who exactly knows why some people present as they do?


Sicko; a documentary about how health care insurance works for profits, but not for health..

On Friday 26 May 2017 the combined NHS campaign groups in the area, North Kirklees NHS Support Group, Dewsbury KONP and Save Our Accident and Emergency fb, following a successful fund-raiser on St Patrick’s Day, showed the documentary Sicko, about the US insurance industry…prompted by comments from the public in the town, that maybe an insurance system would be a good idea for health services in England. The New Picture House in Church Street Dewsbury, was the perfect venue. The organisers express their thanks to all involved at the New Picture House.

Following the film, audience member Patricia Foley said “The shocking thing about ‘Sicko’, is that it’s about people in the US WITH health insurance. People who, if they became ill with ‘expensive’ conditions such as cancer or heart problems, found their insurance companies would refuse to help, simply on cost grounds. More shocking still though, is the fact that these same US companies are being given the green light by this government to do the same thing here, in the name of the NHS.”

Audience member Adrian Cruden said “We all too often take our NHS for granted, assuming it will always be there. The film showed just how awful the alternatives would be. Millions of Americans even now, have no insurance but even those with it face appalling limitations on what is paid for. 

Patient after patient WITH insurance was denied vital care on spurious grounds they hadn’t pre-arranged the emergency ambulance taking them to hospital in a coma; or they took their fitting 7 year old child to the wrong company’s provider’s hospital (she was untreated and died). In one town, private hospitals were dumping elderly confused patients with insufficient insurance cover, in bare feet and hospital gown in the street near a charity shelter at a rate of one a week.

A society is defined by how it treats its sick and vulnerable and elderly. By the evidence of the film, it is difficult to describe the USA as a society at all; its surrender to the profiteering elite and its wicked willingness to countenance infants dying for the sake of shareholder dividends put it beyond the pale. God help us that this is the future Theresa May, Jeremy Hunt and Philip Hammond hope to lead us towards.”


Audience member David Smith said “The film was a reminder how disastrous a private free market insurance health system is! Upsetting and funny in parts. The film illustrated how health care was (in 2007) better in the UK, Canada, France and even Cuba than in the US!
Brief speeches before and during the intervals explained changes since 2006. The 2012 Health and Social Act effectively abolished the legal framework of the NHS.

I wish I had seen this film earlier.
Audience member Jenifer Devlin said “It is now very clear that the Government wishes to abolish the NHS and drive us down the road of private healthcare insurance. The consequence will be that we will lose universal access to healthcare for all: private insurance companies will pick and choose who they insure, they will quibble over claims and they will do all they can to avoid paying out. More and more money that should be spent on healthcare will go into the whole bureaucracy of claims, administration and private profit. We know this from the American healthcare model, where profits come before people, families are plunged into debt and destitution through illness and many people have no insurance at all. I’m 68 and apparently in good health, but I need another replacement hip and knee and like everyone else of my age I have a history of other ailments, any one of which would be enough to deny me private healthcare. And who knows what other conditions might be lurking, yet to be diagnosed? So who, when the Government abolishes the NHS and brings in private healthcare insurance, will be willing to insure me? Kaiser Permanente, United Health or any of the other US healthcare giants are going to reject me out of hand, as they will the majority of other people of my age. A National Insurance and tax funded system was designed to spread the risk over the whole population; private healthcare insurance is  designed to exclude people who might dent the profits of the insurance companies.”

Audience member John Francis said, “ The introduction was interesting. It seems health was on the agenda at the World Economic Forum in 2012. Simon Stevens was working for United Health then and his West Yorkshire STP looks set to put in place steps from a report for the World Economic Forum following the banking crash. The World Economic Forum is made up of transnational business, governments, and media. So it looks like transnational business and the Government which replaced the National Health Service with the Social Care Act 2012, are shaping the English health service to their own ends, with media support and with the doctors, nurses and health of the ordinary person as a side issue. So who’s taken control there? Not you or me that’s for sure.”

The film was organised before the announcement of the election.

West Yorkshire Sustainability and Transformation Plan

Rob Webster, West Yorkshire & Harrogate STP leader, is a World Economic Forum global corporate stooge

West Yorkshire and Harrogate Sustainability and Transformation


Plan leader Rob Webster was among the World Economic Forum workshop participants who supported the 2012 World Economic Forum project to produce reports, co-scripted with privateering global management consultancy company McKinsey & Co, on “sustainable health systems”.  Remember, “sustainable” is code for “cuts”.

2012 was the year when the World Economic Forum opened the throttle on the Shock Doctrine – when global corporations made the most of the global economic shock that resulted from the banksters’ crash to impose their own profiteering practices on governments and public services as well as on faltering and failing businesses that they gobbled up and asset strip. The World Economic Forum 2012 called this “The Great Transformation: Shaping New Models”

The Sustainability and Transformation Plans are basically the World Economic Forum/McKinsey reports on “sustainable health systems”, applied to the NHS in England.

Along with Rob Webster, Amanda Doyle the Sustainability and Transformation Plan leader for Cumbria was another participant in the World Economic Forum workshop on the first of the “financially sustainable health system” reports.

Simon Stevens acted as Project Steward of the Steering Board for the first World Economic Forum sustainable health system report. On the Steering Board, he worked with chief executives of leading healthcare companies such as Apax Partners, Novartis, Merck, Medtronic and Kaiser Permanente, as well as the Directors of Health at the World Bank, the WHO, and the European Commission. At the time Stevens was head of United Health’s Global Division, rather than chief executive of the NHS, though some might argue the roles are interchangeable.

The Working Group of experts who “supported the projects approach and methodology” included Michael MacDonnell, then Senior Fellow from Imperial College’s Centre for Global Health Innovation, now acting as head of policy for the STP framework as a whole.

What does this matter? Well the World Economic Forum, which meets at Davos, is where the transnational capitalist class does its work of extending the influence of global corporations as a whole. This can clearly be seen in the policy framework of STPs. Rob Webster, Amanda Doyle, Simon Stevens, Michael MacDonnell and the rest of them are stooges for global corporations and we should kick them out of the NHS now.

Thanks to the Devil’s Dictionary of Healthcare for this information.

Simon Stevens is now a member of the WEF Value in Healthcare project Executive Board which this year has produced a report called Value in Healthcare Laying the Foundation for Health System Transformation. It sounds like what is going on in the STPs with the Right Care/ ACOs fixed population budgets stuff that is at the root of increasing restrictions and denials of care,  in order to limit treatment to patients who offer the best return on investment.

Exciting Free Film show organised by campaign group

Following a successful fundraiser in the Parochial Hall Dewsbury, The New Picture House will be hosting a film exploring the ‘insurance led’ ‘health industry’ in America.

The New Picture House Church Street Dewsbury, close to the bus station and  the Minster, next to Heron Foods and just down Wellington St, down to South St and  round the corner  if you are arriving by train.

Free film show
Friday, 26 May 2017: 7:30pm
Doors open 6:45pm
The New Picture House
Church Street Dewsbury WF13 1LB, next to Heron Foods
‘Sicko’ a film investigation into the healthcare system in America.
What could a future without a universal NHS, be like?
Licensed bar, food (veggie curry £4, cakes) tea, coffee etc for sale.
Free entry but seats limited so to reserve your place
Enter your name and how many reservations you want
in the comments box at:-
Your details will not be visible.

Free Film Programme
6:45pm doors open. Order drinks and food if required, at the
bar, ready for the interval.
7:30pm Introduction and Film begins, ….showing until the
food, drink, comfort break, for 10 to 20 mins
10:30pm approx, film ends, retire to bar for drinks and
questions, if desired.

Reserve your seat using the comments box on this site, leave your name and how many seats you need reserving.

We’re fighting to save all services at Dewsbury Hospital. Two extra wards is just the start.

Dewsbury Hospital reconfiguration in the slow lane. Assumptions were wrong in 2013!

Main entrance to Dewsbury District Hospital

Next Phase of Mid Yorkshire Hospitals Trust acute reconfiguration.

No definitive timeline was given in the Full Business Case, although it was expected that all the changes would happen by the end of May 2017.

The assumptions made in 2013 about ‘Care Closer to Home’ reducing the number of people having to stay in hospital for treatment were wrong. More people than planned for, are needing to stay in hospital for medical care. The failures in the Care Closer to Home(CC2H) programme have been exacerbated by the ‘drive time of ambulances’ whatever that means ..presumably what campaigners said all along, that journey times from Dewsbury to Pinderfields were unacceptable (compounded by the changes to service sites at Leeds Teaching Hospitals so now, Leeds specialisms are further away than Pinderfields, for Morley patients according to Deborah Turner). The North Kirklees CCG Governing Body member Deborah Turner, admitted at the meeting of Governing Body North Kirklees CCG in parallel with Wakefield CCG, on 6thApril 2017, “Drive time of ambulances has also impacted on the inability to reduce beds.”

Yorkshire Ambulance Service(YAS) has had “input into the ‘model’ before it went to the Star Chamber”, said Jo Webster, CEO of Wakefield CCG. But did the Star Chamber look at aspects of staffing at the Ambulance Trust? Deborah Turner said that there was a risk of reduced staffing in the hospitals although there were no financial restraints on staffing at Mid Yorks and it has been actively recruiting, not least because a number of EU nurses have returned home.

The members of the Governing Bodies at the meeting had to approve the recommendations of the Star Chamber looking into the problems surrounding the full business case(FBC) of 2013.

It is recommended that the Governing Body approve the recommendations of the the Star Chamber held on the 23rd March 2017

as follows

  • To agree that hospital beds cannot be taken out of the system as originally planned to enable medical reconfiguration, as per Meeting the Challenge Full Business case, at this time

  • To agree the system mitigation is robust to support additional beds in the system

  • Agree deferral of the planned medical reconfiguration

  • Support the proposed phasing of changes between April 2017 and September 2017, subject to further QIA and Star Chamber process to assess the risks and mitigation of full implementation of the hospital frailty model, changes to acute inpatient services and critical care prior to implementation

  • Support the proposed reduction in the surgical bed base acute inpatient services and critical care prior to implementation

  • Support the proposal to develop enhanced rehabilitation services at Dewsburyand Pontefract, including rehabilitation for patients with fractured neck of femur in line with national best practice guidelines and with the commitments set out in the original FBC.

Dr Phil Earnshaw, Chair of Wakefield CCG was very keen to stress that this is ‘Phase One only’ that the CCGs were supporting at this meeting, because the implementation of the Multispeciality Community Provider model, due to be coming soon, would change the landscape yet again.

The Star Chamber process is ‘designed to assure patient safety’. So that’s all right then!

The notes on the background to this meeting say “Dewsbury Hospital now has a Children’s Assessment Unit (CAU) open 10am to 10pm.” This was no use to the woman on the bus traveling home from Pinderfields with her toddler, who had fallen and cut his face, just above the lip. She had presented with him at Dewsbury A&E and was sent straight to Pinderfields for which she had to hire a taxi.

All they did was glue it and put a plaster on” she said. “They could have done that at Dewsbury.” Keep All Services At Dewsbury hospital asks

  • So where is the 24/7 minor injuries unit in Dewsbury Hospital now?

  • Is there an age limit for accessing this Minor Injuries Unit facility?

  • Is the denial of care at Dewsbury part of the ‘managed care’ strategy which would see a low income or ‘strapped for time’ family, choose not to hire a taxi to get to Pinderfields therefore not get their child seen? Or just lack of staff?

In the ‘80s and ‘90s, there was much chatter in the press about negligence in families and great encouragement to present children who had experienced accidents, to medical facilities to be ‘checked out’. Has this attitude been abandoned on the alter of commercial decisions? Who decided that?

  • Is this a deliberate attempt to run services down, so that a Multispecialty Community Provider in a GP clinic somewhere, appears better?

The documents also state “Dewsbury Hospital has a new purpose built midwife led birth centre.” However in answer to a question about numbers of transfers to Pinderfields, from the Birth Centre, North Kirklees CCG Quality and Safety Officer Deborah Turner said “the Bronte Birth Centre is operating at a low threshold at the moment so there are more transfers.” This chimes with stories we have heard where women in labour, are whisked to Pinderfields without it being explained properly. Why? The documents state “ More than 100 babies have been born at the new midwife led unit at Dewsbury and transfer rates are consistent with the original plans.” It was revealed much later than the Meeting the Challenge Consultation, that MYHT was expecting a transfer rate of 30% to Pinderfields, however, it seems that Deborah’s answer indicates the papers are out of date at the time of this meeting on 6th April!

Other out of date examples are the mentions of complex colorectal surgery, which according to anecdote must be available occasionally rather than routinely, and the children’s example of the cut lip..

Have you been ‘Consulted’ about the changes to stroke services highlighted in the Sustainability and Transformation Plans…now Partnerships?

Jo Webster of Wakefield CCG assured the Joint Scrutiny Panel for all the councils in the ‘West Yorkshire Footprint’ STP in Leeds on 23 January 2017, that no changes will take place until there has been a Consultation.

The April 6th 2017 meeting discussed the development of rehabilitation services for both stroke and fractured neck of femur patients at both Pontefract and Dewsbury Hospitals. The Star Chamber supported the proposal if they were assured that

  • the model will be a partnership between medical staff, nursing and therapies

  • staffing models will be developed to ensure sufficient capacity to meet the needs of patients

  • Pathways will be designed in such a way that patients would be transferred to beds on each of the hospital sites according to their place of residence transfer will take place when the patient no longer needed surgical intervention and could be safely managed by the medical rehabilitation team.

This last point chimes with something that was said by Martin Barkley at the MYHT Board Meeting on 13th April 2017. Apparently the Clinical Lead on Stroke services at MYHT is not happy about the changes to stroke services SO Mid Yorkshire needs to make Pontefract a ‘Centre of Excellence’ for Stroke rehabilitation as an antidote. Sad then that patients who live in Dewsbury will not be at a centre of excellence! Sandra Cheseldine Lay member for Wakefield CCG said that they must make sure patients don’t go to Dewsbury who live in Pontefract but her question where do Wakefield patients go was not satisfactorily answered as far as Keep All Services at Dewsbury Hospital was concerned.

Deborah Turner, in the meeting in parallel said that monitoring where patients go is a central part of the plans. Fatima Khan-Shah lay member for public engagement at North Kirklees CCG, said ‘engagement needs to be done to keep the public up to speed.’

Watch out then for the Look North slots, leaflets at the Al-Hickma Centre and Ravenshorpe community groups. “If 500 people get to hear about the changes then they then spread the news” said Fatima Khan-Shah. Dr David Kelly, Chair of North Kirklees CCG said that GPs also need to be involved in ‘engagement’. Have you been engaged with or ‘Consulted’ about any of this? What happened there?