Over the weekend I’ve received some e-mails from local residents linked to We Own It’s It’s our NHS: Don’t Slash, Trash and Privatise campaign
Dear Cllr Paul Bull.
You may be aware that the government is dividing the NHS in England into 44 areas or ‘footprints’, each of which has a ‘Sustainability and Transformation Plan’ (STP). I believe that these plans are intended to help the government to Slash, Trash and Privatise our NHS – leaving local areas to deal with the crisis that follows.
Jeremy Hunt wants to force councils to quietly sign up to an NHS that simply cannot meet people’s needs within the budget he has fixed.
Privatisation is already part of the waste problem causing this crisis – the market in the NHS costs at least £4.5 billion a year. But these cuts will also lead to more privatisation in turn as the NHS struggles to cope with the pressure.
This is all happening behind closed doors. Only 15 of the 44 plans have been published. The plans are due to be signed off completely by Christmas – yet the public still hasn’t seen most of them.
These plans are dangerous. I don’t want to see an NHS that says ‘sorry, this hospital is closing, you need to travel further to have your baby or deal with your emergency’. I don’t want to see more privatisation.
I am writing to ask you to do two things
1. Demand that the ‘Sustainability and Transformation Plan’ for our ‘footprint’ area is immediately released for public consultation. (The following plans have already been released but need scrutiny: Newcastle, Tyne & Wear • Durham, Darlington, Teesside, Hambleton, Richmondshire & Whitby (Footprint 3) • W Yorkshire • Birmingham & Solihull • Bedfordshire, Luton & Milton Keynes • N Central London • NW London • SE London • SW London • Gloucestershire • Somerset • Dorset • Devon • South Yorks and Bassetlaw • Lancashire and South Cumbria)
2. Oppose the local plan to Slash, Trash and Privatise and refuse to sign up to it. It is part of a bigger plan by government to undermine our NHS as a public service through cuts and privatisation. Some brave councils are already taking a stand for our NHS. Hammersmith and Fulham, Ealing and Sutton councils have refused to sign up to the plans. This is the right thing to do.
Steve Cowan, leader of Hammersmith & Fulham council said: “This is about closing hospitals and getting capital receipts. It’s a cynical rehash of earlier plans and is about the breaking up and selling off of the NHS. It will lead to a loss of vital services and will put lives at risk. Our job is to protect the NHS and this plan is about dismantling it.”
The plans will mean reducing the number of A&E hospitals from 140 to less than 70 across England and cutting hospital beds – while hoping that care in the community (also being cut) will pick up the slack. The plans also include selling off land and assets that belong to the NHS. They include huge shortfalls of millions of pounds – patients just can’t be cared for properly without more funding. The plans may include some good ideas, but overall they are unrealistic about funding and include untested assumptions.
The former head of NHS commissioning Julia Simon has denounced the STP process as ‘shameful’, ‘mad’, ‘ridiculous’ and the plans as full of lies. Only 16% of NHS finance directors believe they can deliver on STP plans.
NHS England health plans assume partnership with local authorities and they imply shared responsibility for the (potentially very serious) consequences. That means you can play a crucial role by refusing to sign up to these plans. This is about local democracy – councils should not allow themselves to be forced into signing these plans.
For more information see the We Own It website: https://weownit.org.uk/blog/its-our-nhs-dont-slash-trash-and-privatise
Health Campaigns Together has a guidance document for councillors here: http://www.healthcampaignstogether.com/pdf/Resource%20pack.pdf
Please don’t sign up to Slashing, Trashing and Privatising our local NHS.
Thank you for your time.
My reply to them is here:
Thank you for contacting me about the Government’s plans for our National Health Service, and your fears that they are using their Sustainability and Transformation Plans to Slash, Trash and Privatise the NHS.
It is e-mails such as yours that give me hope that Nye Bevan was right: “The NHS will last as long as there are folk left with the faith to fight for it.”
You say you are writing to me to ask me to do two things:
1) Demand that the STP for our footprint area is immediately released for public consultation.
The Wider Devon STP was originally leaked in the summer, and the latest draft was published on Friday 04 November 2016.
2) Oppose the local plans to Slash, Trash and Privatie, and refuse to sign up to the STP.
The local authority responsible for public health and well-being for Exeter is Devon County Council, and so I – and my co-councillors on Exeter City Council – will not be asked to sign-up to the STP.
However, with that said I will continue to lobby my County colleagues to oppose STP unless it works for the residents of Exeter and Devon.
And I hope that you have contacted your local County Councillor – Cllr Roy Hill [for Alphington and Cowick] or Cllr Rob Hannaford [for Exwick and St Thomas].
The DCC Health and Wellbeing Scrutiny Committee met on Tuesday 08 November 2016 and considered a report by Jenny McNeill, Associate, NEW Devon CCG.
The Scutiny Committee were concerned that they had no time to read the full STP document before considering the report, so It was MOVED by Labour’s Chair of the Committee, Cllr Westlake, SECONDED by Councillor Sellis and
RESOLVED that a special meeting of the Committee be arranged (for early December) to consider in detail the recently published Sustainability and Transformation Plan for wider Devon.
I believe this special meeting has so been arranged be held on Thursday 15 December.
And just today the King’s Fund has publishedpublished a report on STP:
Sustainability and transformation plans in the NHS: How are they being developed in practice?
The report suggests that the STPs offer the best chance for health and social care leaders to work together to improve care and manage limited resources. But will the report also questions whether the plans will succeed where other initiatives have failed?
In particular, the Kings Fund is concerned that little is known about the process of developing the plans and how the initiative has worked in practice.
– Despite the focus on local ownership, key elements of the process have been ‘top-down’;
– National requirements and deadlines for the plans have changed over time, and guidance for STP leaders has sometimes been inconsistent and often arrived late;
– The approaches of national NHS bodies and their regional teams have not always been aligned;
– Tight deadlines have made it difficult to secure meaningful involvement in the plans from key stakeholders, including patients and the public, local authorities, clinicians and other frontline staff; and
– Organisations face fundamental policy barriers to working together on STPs; existing accountability arrangements focus on individual rather than collective performance.
Based on these findings, the report makes a number of recommendations for the future of the STP process. There is a need to:
– secure the meaningful involvement of patients and the public in the plans, alongside clinicians, other frontline staff and local authorities;
– develop governance arrangements that allow organisations to make collective decisions and share accountability
– improve national co-ordination and leadership of the STP process;
– ‘stress-test’ STPs to ensure that the assumptions underpinning them are credible and the changes they describe can be delivered; and
– focus on the skills and resources needed to implement STPs, as well as the cultural aspects of making change happen.
And on the national scene, the National Health Action Party has published 5 Things You Should Know About STP.
However, that’s not the end of it – the plans for the NHS here in Devon go deeper that the Wider Devon STP.
NHS Funding was the subject of an Opposition Day debate in the House of Commons recently, when Ben Bradshaw challenged the Secretary of State for Health, Jeremy Hunt:
Ben Bradshaw [Labour] [Exeter]
The Government have been well and truly found out on this issue. Rather than quote selectively from Simon Stevens, the head of the NHS, will the Secretary of Stateconfirm that among the conditions that Mr Stevens put down to the Government as part of the five-year review was an increase in public health spending, not a 20% cut, and a policy of maintaining spending on social care? Will he also confirm—he was there in Simon Stevens’ presence before the Select Committee—that Mr Stevens made it quite clear that those conditions and others had not been met?
Jeremy Hunt The Secretary of State for Health
Mr Stevens said—I was there—was that social care and, indeed, public health provision needed to be maintained. We are increasing the social care budget by £3.5 billion over this Parliament. Although I accept that difficult cuts are being made to the public health budget, we are doing other things that do not cost money to make sure that we continue to improve this country’s excellent record on public health.
The full debate can be found in Hansard v616 31 October 2016
“No more pointless reorganisations.”
David Cameron, speech to Conservative Party conference, 4 October 2006
Andrew Lansley, Conservative Party press release, 11 July 2007
In their 2010 manifesto , the Conservatives promised that they would cut bureaucracy in the NHS.
“We will decentralise power, so that patients have a real choice. We will make doctors and nurses accountable to patients, not to endless layers of bureaucracy and management.”
Conservative Party manifesto, April 2010, p. 45
These promises were repeated in was repeated in the Coalition Agreement.
“We will stop the top-down reorganisations of the NHS that have got in the way of patient care.”
Coalition Agreement, 20 May 2010, p. 24
Despite these promises, what we did see was that the Tory-led Coalition Government – with the support of their Liberal Democrat allies – imposed the biggest top-down reorganisation in NHS history.
Yet under Andrew Lansley, all those promises were broken.
The Health and Social Care Act introduce new layers of bureaucracy into the NHS. New quangos created by the Tories include: Public Health England, Health Education England, Clinical Commissioning Groups, National Commissioning Board, SHA Clusters, PCT Clusters, Healthwatch England, NHS Property Services and Commissioning Support Services. According to the Royal College of GPs,the reorganisation moves the NHS from having 163 statutory organisations to 521.
For more, see Open Democracy’s Cameron’s betrayal on the NHS.
The cynic in me was always sceptical when the Government set up the CCGs – especially here in Devon. I believe they were set up to fail.NEW Devon CCG, which covers Exeter, is the biggest CCG in the country. Yet when it was set up by Lansley’s Health and Social Care Act, was NEW DevonCCG funded to cope with the demands of local patients? I maintain not.
And now, according the BBC [12 February 2016], it faces an anticipated deficit of £430m by 2019 – and despite cost-saving measures of £239m, under current plans the CCG would still be short by £191m in five years.
So what has happened it that central Government has been able to absolve itself for the responsibililty of any cuts – with the added bonus being that hey can claim it was made by local people – including local clinicians and GPs!
As a result, NEW Devon CCG has been put into “special measures”, the Success Regime.
The reasons given for why NEW Devon was selected include:
–– Increasing health community deficit forecasts;
–– A lack of working together to develop a system wide service and financial strategy.
In September 2015 , Judith Dean, a former nurse who more recently has worked in transformation at Wiltshire CCG, was appointed as programme director. Carnall Farrar, a healthcare and public services management consultancy, were selected to provide consultancy support following a competitive tender. Dame Ruth Carnall, former chief executive of NHS London (and co-founder of Carnall Farrar), will take on the role of chair.
In February 2016, Devon success regime published the Case for Change, which outlines the financial and quality challenges to delivering care locally.
But even now, the Success Regime has been redefined with the publication of the STP.
It appears to me that the STP can only succeed if costs are reduced. And there is only one way to do that – refine need.
One of the proposed ways of doing that seems to be to close hospital services in North Devon. Not only will this be disasterous for the people of North Devon, this will place additional burdens on out own RD&E Hospital.
In addition, NEW Devon CCG is proposing a series of reductions to community beds across Devon – these proposals are outlined in the Your Future Care consultation document
Apparently, it is all about deciding the location of community hospital inpatient beds in the Eastern locality while giving people reassurance as to the improved care they can expect instead, in their own homes.
The proposals have been expressed as four options, outlined in full below. In addition to the consistent and enhanced provision of community health and social care delivered in people’s homes, the services will be supported by consolidated community in-patient beds in the following possible configurations:
Option A Beds at Tiverton (32), Seaton (24) and Exmouth (16)
Option B Beds at Tiverton (32), Sidmouth (24) and Exmouth (16)
Option C Beds at Tiverton (32), Seaton (24) and Exeter (16)
Option D Beds at Tiverton (32), Sidmouth (24) and Exeter (16)
Option A is the preferred option of the CCG – it thinks this combination results in the smallest impact in travel time and has the greatest benefit to the whole pathways of care
Members of the public are invited to respond to the Your Future Care public consultation by Friday 6 January 2017.
In addition to the on-line consultation , NEW Devon CCG has organised a series of public events
The Exeter-based events are:
Friday 18 November: 14:30 – 17:00 – Whipton Community Hal, Pinhoe Road, EXETER EX4 8AD
Monday 21 November: 18:00 – 20:00 – St Luke’s Sports and Science College, Harts Lane EXETER EX1 3RD
And the CCG have promised additional events if the demand is there.
There is no doubt that the NHS is under threat from the Tories – both locally and nationally.
To that end, I am planning to support the Labour’s Day of Action on the NHS, taking place across Exeter on Saturday 26 November.
The Save Our Hospital Services held a successful Devon Sees Red event in Barnstaple on 22 October 2016
And now SOHS plan a Save Devon’s NHS Rally for Exeter on Saturday 03 December. The theme is easy – turn up and wear RED
In conclusion I would like to echo some of the themes being promoted by the People’s Red Line campaign, which calls on the Government to implement 3 simple reforms:
2. Remove parasitic privatisations; and
3. End the internal market that has more than doubled management costs in the NHS
2. Taking part in collective action for lasting change.
I hope the above clarifies my position on STP
Cllr Paul Bull
Labour and Cooperative Councillor for St Thomas