My reply to We Own It’s “It’s our NHS: Don’t Slash, Trash and Privatise” e-mail

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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.

Key findings:
– 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.

Policy implications
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.

If you need more information on the local situation, this guide – published by Save Our Hospital Services in North Devon – provides a good grounding in what the STP means for Devon.

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.

It must be stated that what’s currently happening to the NHS nationally is a political decision, not an economic necessity – and the changes we’re seeing are a result of Tory dogma.
During Labour Governments up to 2009-10, UK NHS spending rose to near the average of comparable economies – but since 2010 it has fallen sharply.
UK spending on healthcare is significantly below the average of major European economies. If the UK were to increase its spend to 10.7% of GDP, this would equate to an extra £15bn of funding.
The table below shows the current status after 5 years of Tory Government:
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 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
https://hansard.parliament.uk/commons/2016-10-31/debates/ED226001-FBBB-4E28-9675-5ECF5840931E/NHSFunding

So, although its Tory dogma, it wasn’t what they promised, was it?  I remember well, those Tory promises.
Before the 2010 general election David Cameron repeatedly promised that there would be no more top down reorganisations of the NHS.
So I make this commitment to the NHS and all who work in it.
No more pointless reorganisations.”
David Cameron, speech to Conservative Party conference, 4 October 2006
The NHS needs no more pointless organisational upheaval. It needs no more top-down reorganisations.”

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

Your Future Care consultation events
Your Future Care consultation events

The Exeter-based events are:
Friday 18 November14:30 – 17:00 – Whipton Community Hal, Pinhoe Road, EXETER EX4 8AD
Monday 21 November18:00 – 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

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SOHS Devon Sees Red event in Barnstaple

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:

1. Fix NHS funding as a proportion of GDP, equal to the average for developed nations;
2. Remove parasitic privatisations; and
3. End the internal market that has more than doubled management costs in the NHS
The People’s Red Line Campaign aim to do this by calling for:
1. The building of a movement to bring back a state funded, a
state provided and democratically accountable NHS; and
2. Taking part in collective action for lasting change.
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I hope the above clarifies my position on STP

Best wishes

Paul

Cllr Paul Bull

Labour and Cooperative Councillor for St Thomas

We Own It | It’s our NHS: Don’t Slash, Trash and Privatise

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It’s our NHS: Don’t Slash, Trash and Privatise

Dear councillors in England – the NHS needs you

The government wants local areas to deliver plans that will Slash, Trash and Privatise our NHS (and to deal with the crisis that follows). But if councils refuse to sign up to the plans, we have a chance of stopping them.

Sustainability and Transformation Plans (STPs) sound nice. In reality, ‘sustainability’ is code for cuts and ‘transformation’ is code for privatisation. There are 44 plans for ‘footprint’ areas across England. The plans – which are supposed to be signed off by Christmas – have mostly been kept secret and the ones that have been released often lack key information. What we do know is that they deliver deep cuts to NHS services and plenty of encouragement to the private sector to get involved.

Councils have to sign off these plans before they can be delivered. Councillors – please say no, don’t sign up to Slash, Trash and Privatise the NHS.

Don’t put lives at risk

The government wants councils to sign up to plans now and commit to drastic cuts that will put people’s lives at risk. The plans are expected to slash the number of A&Es in England from 140 to less than 70. A 38 Degrees investigation showed that the plans include huge shortfalls of millions of pounds – patients just can’t be cared for properly without more funding. Hammersmith and Fulham, Ealing and Sutton councils have refused to sign up to the plans. What does the plan look like for your area? Will it put lives at risk?

We condemn the Tory government for drawing up these plans. 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. This document is an affront to the sensibilities of the people of north-west London.” Steve Cowan, leader of Hammersmith & Fulham council

 

We refused to sign up to the STP plans because we do not support the closure of Ealing and Charing Cross acute hospitals … We have made it abundantly clear that we will campaign until our last breath to save Ealing and Charing Cross hospitals. We do support some of the proposals for more integrated health and social care but we feel we will be punished for not signing up to these plans.” Julian Bell, leader of Ealing council

Warning bells are ringing

Most of the STPs haven’t yet been published.

Those that have been published often don’t include important financial information and evidence.

Julia Simon, the former head of NHS England commissioning, has denounced the STP process as ‘shameful’, ‘mad’, ‘ridiculous’ and the plans as full of lies.

Only 16% of NHS finance directors believe sustainable STPs are achievable by 2021.

The Royal College of Emergency Medicine has said “These plans that are emerging via different routes, if true, are potentially catastrophic and will put lives at risk” as almost a third of CCG leaders are considering closing emergency departments. How would your area deliver its plan? Is it realistic?

Defend our public NHS

Privatisation of our NHS is happening. Last week Virgin won contracts for 200 NHS services in Bath. STPs will increase the pressure to privatise, both by running down the NHS with cuts (so the private sector can swoop in to provide the solution) and through guidance that encourages a key role for private companies in planning and delivering services. An NHS England director has said STPs offer private companies ‘an enormous amount of opportunity’. Is that what people want in your area?

Privatisation wastes public money that could be spent on patient care. We already spend at least £4.5 billion on the NHS market. Private Finance Initiative deals have wasted £250 billion. We need to stop privatisation, not waste more money on it.

84% of the public support the NHS being publicly owned. The government knows privatising the NHS is hugely unpopular. That’s why they’re trying to devolve the decision making to local areas, taking the ‘N’ out of the NHS.

You’re on the frontline

This is it now – you’re on the frontline of saving our NHS. NHS England health plans assume partnership with local authorities and they imply shared responsibility for the (potentially very serious) consequences. That means councillors, council leaders and mayors can play a vital role by refusing to sign up to these plans. This is about local democracy. Please stand up for our NHS.

Don’t sign up to the plans – thank you!

Ask your councillors not to sign up to the plans to Slash, Trash and Privatise our NHS.

Read more on OurNHS: ‘Councillors must look before they leap into secret NHS cuts plans’.

Health Campaigns Together is calling for plans to be released and it has a guidance document for councillors here.

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STP – A briefing pack for councillors

We Own It have also sent an e-mail to councillors,

Dear Paul

The Government is trying to force local areas to Slash, Trash and Privatise our NHS through so-called ‘Sustainability and Transformation Plans’ (STPs). Ignore the silly words – these plans are about cuts and privatisation.

Some brave councils are taking a stand for our NHS. 20 councils have released the plans to the public, and Hammersmith and Fulham, Ealing and Sutton councils have refused to sign up to them. This is the right thing to do.

This is where the fight is at now for the NHS. If councils across the country start resisting the government’s plans, we could actually have a chance of pushing back privatisation of our NHS.

The government is dividing the NHS in England into 44 areas, each of which has an STP. The plans will leave local areas dealing with crisis – and private companies ever more ready to swoop in.

This is all happening behind closed doors. Only 15 of the 44 plans have been published. The government knows the public won’t go along with the plans, that’s why they are being kept secret. The plans are due to be signed off completely by Christmas – we need to see them and stop them NOW.

Say no to slashing, trashing and privatisation

Jeremy Hunt says the NHS needs to go on a 10-year diet. Now he wants to force councils to quietly sign up to an NHS that simply cannot meet people’s needs within the budget he has fixed.The government’s plans would mean an NHS that says ‘sorry, this hospital is closing, you need to travel further to have your baby or deal with your emergency’.Sound familiar? It’s the same old story. Privatisation is already wasting money that could be spent on patients – running the NHS as a market costs us at least £4.5 billion a year. And the cuts in turn are creating an NHS that is ever more vulnerable to the private sector.

“That’s the standard technique of privatisation: defund, make sure things don’t work, people get angry, you hand it over to private capital.”  Noam Chomsky

A few days ago Virgin Care won a contract to run 200 NHS services including adult social care in Bath. STPs will mean more of this. We know these plans are dangerous – they must be stopped across the country.

The NHA Party says that plans will mean reducing the number of A&E hospitals from 140 to less than 70 across England. That means fewer hospital beds, longer ambulance journeys for emergency care, longer waiting times for treatment. The plans also include selling off land and assets that belong to the NHS. And patients using vouchers and personal health budgets, as a form of ‘self-pay’.

A 38 Degrees investigation showed that the plans include huge shortfalls of millions of pounds – patients just can’t be cared for properly without more funding.

The NHS is ours. We don’t have to buy their story.

Let’s all work together to save the NHS we love and make sure people come before profit.

With best wishes

Cat, Matt, Biba and the We Own It team

PS You can read more here https://weownit.org.uk/blog/its-our-nhs-dont-slash-trash-and-privatise

Ask your councillors not to Slash, Trash and Privatise the NHS

[If you’re in England] Sign the 38 Degrees petition asking Jeremy Hunt to reveal the plans

if you’re in Scotland, Wales or Northern Ireland)

Ask your councillors to stand up for the NHS

Wider Devon Sustainability and Transformation Plan [STP]

Wider Devon Sustainability and Transformation Plan [STP]

The Wider Devon Sustainability and Transformation Plan was published as a draft submitted to NHS England in June 2016 and  sets out plans to improve health and care services for people across Devon in a way that is clinically and financially sustainable.

Health and care organisations as well as local authorities across Devon have been working together to create the shared five-year vision to meet the increasing health and care needs of the population – while ensuring services are sustainable and affordable.

The STP provides the framework within which detailed proposals for how services across Devon will develop – between now and 2020/21.

A key theme throughout the STP is an increased focus on preventing ill health and promoting peoples’ independence through the provision of more joined up services in or closer to peoples’ homes.

Seven priority areas have been identified as key programmes of work:

  1. Ill health prevention and early intervention
  2. Integrated care model
  3. Primary care
  4. Mental health and learning disabilities
  5. Acute hospital and specialist services
  6. Increasing service productivity
  7. Children and young people

The latest draft of the Wider Devon STP to reshape health and care services in Devon, Plymouth and Torbay by 2021 was released on 04 November 2016.

It is planned that the document will be presented to all partner organisation boards or equivalent bodies for consideration and endorsement over the next six to eight weeks.

Following this, the organisations involved will then undertake an engagement exercise involving citizens, patients, service users, their representatives and voluntary sector groups. Feedback will further help shape the plans.

The NHS and its partners will then use the STP framework to develop proposals to improve care.

One of the first organisations to consider the revised draft of the Wider Devon STP was Devon County Council’s Health and Wellbeing Scrutiny Committee, who met on Tuesday 08 November 2016, where the members considered a report by Jenny McNeill, Associate, NEW Devon CCG .

The minutes of the meeting note:

Councillors Brazil and Hawkins attended in accordance with Standing Order 25(2) and spoke to this item on the likely impact of service changes arising from the Plan (and subsequent consultations) on health service provision in their respective localities).

Dame Ruth Carnall, Ms A Pedder and Ms L Nicholas attended and spoke to this item at the invitation of the Committee.

The Committee considered the report of the Sustainability and Transformation Plan (STP) Team for wider Devon on the Plan which had been formally published on Friday 4 November (and circulated to all members of the Council). The STP was the local plan to achieve the NHS ‘Five Year Forward View’ published in October 2014 and designed to provide the overarching strategic framework to achieve safe, sustainable and integrated local support by 2021 and on closing the financial gap that existed,  recognising that doing nothing was not an option.  The report covered the timeline and the next steps.

The representatives also gave a presentation covering: the Sustainability and Transformation Plan (STP) and its footprint and the NHS organisations involved, and also included care quality and financial challenges, priority areas and aspirations.

The representatives responded to Members’ questions relating to:
· the role of local members in calling for additional resources from Government noting that the STP was developing within current resources
· the scope for additional one-off funding in respect of transition arrangements arising from changes
· challenges in delivering services as a result of changes
· information in the ‘Case for Change’ about comparative costs of acute beds vis a vis costs of care at home, which the representatives undertook to provide to members of the Committee.

It was MOVED by Councillor 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.

Further reading:
Devon-wide STP briefing document

Acute hospital services review