Archive | January, 2013

Lewisham: closure plan sets precedent that makes it unnecessary

31 Jan

This from the blog of “skwalker1964” <comment+pgk64940e1lyqf80vhv9f31c@comment.wordpress.com>

I came across a very interesting snippet in the transcript of last Monday’s House of Lords debates, which drew my attention to something I hadn’t been fully aware of before.

You may already have heard about the government’s planned closure of the Accident & Emergency (A&E) and maternity units at Lewisham NHS Trust, and about the mass protests of residents against the closures, as local people are trying to prevent the government from closing facilities that are crucial to the health and wellbeing of surrounding community.

What you might not be aware of is why the government wants to close these critical units.

In the Lords the other day, Labour peer and former Minister Lord Tomlinson challenged a government representative about the closures:

Will the Minister accept that the proposals to close the excellent and much-admired accident and emergency hospital in Lewisham, and to downgrade its maternity services, have been made not because there is anything wrong with the hospital but because a government-appointed administrator has said that that should be done in order to help the neighbouring National Health Service trust, which has run up £130 million-worth of debt? Will she accept that closing and downgrading good facilities is an act of almost criminal stupidity, which leads to nothing but increased health inequalities when the Government’s objective is to reduce them?

Yes, you read that right. Lewisham A&E – which only months ago underwent a multi-million pound upgrade – is to go because of debts at a completely different Trust., to which it is unconnected except by virtue of being part of the same National Health Service.

It’s well-known that time is of the essence when it comes to treating emergency cases – any additional delay can worsen outcomes drastically, even resulting in death (just think of the ‘Act FAST’ advertising campaign stressing the importance of urgent recognition and action in stroke cases). The people currently served by Lewisham A&E face having their lives and health put at risk by a longer journey for treatment at a unit elsewhere in London, while mothers and babies face a greater threat if there are complications during labour.

But as well as ignoring the wishes and welfare of people in and around Lewisham, the government is also demonstrating the truth of something which it generally tries to deny. The administrator placed by the government in charge of South London Healthcare Trust (SLHT), the ‘financially-challenged’ Trust mentioned by Lord Tomlinson, has recommended closure of facilities at neighbouring Lewisham because this will apparently help the SLHT.

The government – for its own venal purposes – has been insistent in treating hospitals and Trusts as individual organisations, each with its own budget and its own responsibilities. But by considering the closure of facilities at one Trust for the sake of another, the government is recognising the principle that the NHS is one organisation, and individual Trusts are all part of a single whole. Like a field of mushrooms that are really all part of the same system.

Image

And that simple fact, obvious to everyone who truly loves the NHS, but denied by this government up to now, means that the closure of any facilities in Lewisham is completely unnecessary to save the South London Trust.

Why?

As I showed in a post last month, the NHS ran at a surplus last year of £1.6bn – enough to clear the South London debt more than 12 times over. Rather than use this for the good of patients or to solve the debt problems of struggling hospitals, the Treasury stole (or ‘clawed back’, as it calls it) at least £1.4 billion to add to its ‘savings’ from the government’s brutal cutbacks to fund tax-cuts for the wealthy.

There is plenty of money within the NHS to make SLHT’s debt problems a dim and misty memory. All the government has to do is start treating the NHS as a whole and not as a range of individual, fragmented pieces, and then use the surplus as needed to restore health and balance to the system.

That the government is making a choice not to do so shows the utter falseness of the Tories’ claim to value the NHS and of their promise to protect it. It also gives away their strategy to break the NHS up into ‘manageable portions’ that they can starve into submission and then dispose of piecemeal to their friends and backers.

But in even considering the SLHT administrator’s recommendations for Lewisham, the government is unwittingly admitting that the NHS is one entity, with each part linked to every other, and the whole organisation responsible for supporting every part.

Admitting, too, that there is no need to close anything at Lewisham. I hope the campaigners can take the government’s own precedent to mount a strengthened legal and political challenge to the government’s attack on their services and well being.

Advertisements

Private Companies exploiting People with Disabilities

28 Jan

I don’t really care whether Samuel Johnson, Gandhi or Truman said it, the truth of the statement still holds:

“The measure of a society is how it treats its weakest members”

So if you think privatisation of health and care services will improve the measure of our society in England, if you think private companies are going to help the NHS work better and care for the sick, the poor, the disabled and those with mental illness, just take a look at where it’s going at the moment.

A BBC Panorama programme tonight investigated if one of the government’s most ambitious welfare reforms, costing billions of pounds, could solve the problem of disability unemployment. Reporter Sam Poling revealed the private companies who are getting rich from the new reforms despite only being able to get a small fraction of disabled people back to work, and spoke to the charities who feel the most vulnerable in our society are being failed.

Watch it on iPlayer if you missed it and despair for the future of this country.  http://www.bbc.co.uk/programmes/b01qgk9h

Privatisation of GP Surgeries

28 Jan

I know the report below is from late last year, but this issue isn’t going away any time soon and in April the new Clinical Commissioning Groups take over.  In North Somerset the Lay Chair of the CCG, who is also the public and patient involvement officer, declares her interests as being a consultant to Capita Symonds – http://www.capitasymonds.co.uk/sectors/sectors/health.aspx.  Also her husband is a director of the Bristol University Hospital Trust.

Channel 4 News Reporter Morland Sanders wrote about making Getting Rich on the NHS for Dispatches on Monday 29 October 2012

Most patients on the Kings Heath estate in Northampton haven’t got the time to read the 460-page Health and Social Care Act but they have already had a taste of the potential impact it may have on the NHS in their neighbourhood.

The controversial and complex piece of legislation, drawn up by former Health Secretary Andrew Lansley, encourages competition and the increased involvement of private companies in the health service. It’s an issue the Kings Heath patients are already familiar with as their medical centre was taken over by a private firm in 2010.

The Kings Heath health provider is a household name but one more readily associated with the glitz and glamour of pioneering pop music, trans-continental jets and edge-of-atmosphere space travel. However, for the last two years Sir Richard Branson’s Virgin has been involved in the slightly less glamorous world of dispensing flu vaccines and diagnosing piles.

I’ve travelled across England meeting some of those patients left asking the question: ‘Does Virgin Care?’ One Thursday evening I joined a residents meeting in the local community centre. Until two years ago, at the top of the agenda was bin collection or the annual fundraiser. Now the conversation is about a claimed lack of doctors at their local Virgin-run clinic.

‘Virgin, they run airlines and everything else but they cant run a medical centre’, said one of the residents. Their main claims are that when Virgin took over from the NHS seeing a doctor became a challenge, the clinic became far too reliant on locum GPs and the company was not keeping its commitment to provide extended hours access to doctors.

In a statement Virgin told Dispatches: ‘We have made every effort to meet the commitments set out in the press release on our website but there were staffing issues at the practices outside of our control. GPs are available at alternative sites for late opening’.

Virgin promises to provide ‘outstanding service’, but Dispatches found concerns were not confined to just one medical centre. This was evident in Teesside, where the company provides sexual health tests. The service repeatedly missed targets on the numbers of people screened for Chlamydia. A memo revealed staff were asked to take home testing kits to use on friends and family to help make the numbers up.

We showed the memo to health academic Professor Sir Andy Haines, who told us: ‘That’s quite shocking. Screening your family and friends is not the same as screening the population in general and so it seems to me that this is a worrying development.’

In a statement Virgin told Dispatches: ‘The memo was sent out shortly after we took over the running of the programme and, as soon as it was brought to our attention the practice stopped. Virgin Care is a leading provider of high quality and safe NHS services. Virgin Care has now treated more than 2.5 million patients to high levels of satisfaction, improved the NHS services it delivers and saved millions of pounds for the NHS’.

http://www.channel4.com/programmes/dispatches/articles/getting-rich-on-the-nhs-reporter-feature

This is What Happens in the New NHS

23 Jan

Last year, the government launched its NHS “failure regime” for the first time, due to the intractable indebtedness of south London Healthcare NHS trust. With many other NHS trusts in financial difficulty, the process has worrying implications for the NHS in England.

The trust special administrator’s proposed solution involves the effective gutting of a neighbouring hospital – the high performing and financially solvent Lewisham hospital.

Under the proposals, its assets would be sold and income streams diverted to bail out the struggling Queen Elizabeth and Princess Royal hospitals. Lewisham would lose full emergency services and would become an elective centre for south-east London – requiring costly rebuilding, and with no existing model on which to predict success.

In addition, the hospital’s full maternity services would be replaced with a midwifery led unit, again a dubious model in inner city London where the majority of women will be diverted to units that are already busy and will have to be enlarged.

It is claimed this will result in better quality care and sustainable providers for south-east London.

There is no evidence for this and it is not supported by local commissioners – one of the key four tests the trust special administrator (TSA) is required to meet. Even the TSA agrees that Lewisham is a high performing organisation.

As the clinical commissioning group (CCG) chair for Lewisham, I sat on the TSA’s clinical advisory group. The group was barred from considering existing quality as it was assumed any new organisation would automatically meet quality standards. The only arguments permitted were financial.

We were told that five A&Es in south-east London were not affordable, so the number must be reduced to four in future. We were not allowed to question this assumption, and Lewisham – without protected foundation trust status, not linked to long-term PFI debts, and with releasable assets – was the TSA’s obvious target. This was justified by the TSA’s claim that future finances for Lewisham were precarious.

No matter that these figures were disputed by both Lewisham’s CCG and by Lewisham Healthcare NHS trust, and in any case were trivial amounts compared with the debts existing in south London Healthcare NHS trust.

The lessons of Mid Staffordshire, where finances took precedence over quality, are relevant here. Lewisham’s exemplary paediatric services would be lost under reconfiguration, and there is little likelihood their replacement will serve local children half as well.

Lewisham’s maternity services deliver 70% of local babies, so dispersing these to other, already over-stretched units almost guarantees reduction in patient experience and risks poorer outcomes in large, busy units.

Local commissioners have said unanimously this is unacceptable. The local authority has condemned the proposals as harmful to local health and damaging to local finances and the rushed health equality assessment has cited major concerns regarding the proposals.

Despite this, the need for financial balance and perceived requirement for rationalisation has overruled all cogent argument. If approved, this will set us on a risk-ridden course towards poorer services.

Ironically, the proposals do not even make financial sense, as the TSA plans to spend £195m to get £19.5m savings a year.

There is a clear alternative, which is to let GP commissioners do the job they are meant to do, and work with the local healthcare experts and patients to plan the future.

Dr Helen Tattersfield is chair of Lewisham clinical commissioning group and a GP

From: http://www.guardian.co.uk/healthcare-network/2013/jan/22/lewisham-hospital-closure-worrying-precedent-nhs

Two Questions We Want Answering

23 Jan

How can the adverse effects of the Act be independently monitored?

Are there mechanisms by which these effects can be exposed so that the public can understand the reality of the changes and something can be done to protect the NHS?

Next Meeting for Protect North Somerset NHS Group

22 Jan

Protect North Somerset NHS logoNext Group Meeting is 19th February at St Peter’s Hall, Alexandra Road, Clevedon

Next Health Oversight Panel meeting is 28th February at Weston Super Mare

Tory Bloggers say NHS Cannot Be Free at the Point of Use

21 Jan

This is from conservativehome & 2020health blog. #NHS no longer free at the point of use. pic.twitter.com/0lTy5x3j

%d bloggers like this: