Hospital bosses’ “irresponsible” acceptance of £22bn efficiency cuts will harm patient care

The Secretary of Calderdale NHS 38 Degrees campaign group has slammed a statement by Calderdale and Huddersfield hospitals trust’s Chief Executive and other hospital bosses across England, that they’ll accept the government’s proposed £22bn efficiency cuts in exchange for the Prime Minister’s backing for rapid hospital cuts and closures, and funding for “new models of care”.

Among these new models of care are Calderdale’s “Care Closer to Home” scheme, which aims to cut acute and emergency hospital services by taking services for frail elderly and chronically ill patients out of Calderdale Royal Hospital and putting them into the “community”.

Owen Williams, Chief Exec of Calderdale & Huddersfield hospitals Trust, recently co-signed an NHS Confederation letter to the Prime Minister where NHS bosses accepted the government’s £22bn “efficiency” cuts programme for the NHS, while calling on the new Conservative government to honour its manifesto promise of an £8bn extra funding/year to carry out the big changes identified in NHS England’s 5 Year Forward View, plus funding for “transformation” and social care.

NHS England was set up as part of the 2012 Health and Social Care Act, in order to design NHS commissioning organisations and processes and develop their business functions. In other words, to drive the marketisation and privatisation of the NHS.

The NHS Confederation is the NHS head honchos’ membership organisation. Its members are drawn from organisations that plan, commission and provide NHS services.

When the NHS Confederation letter was published, Clive Peedell – the oncologist who founded the National Health Action Party – tweeted,

“Utterly irresponsible for @nhsconfed to sign up to the £22bn efficiency savings program. It will harm patient care.”

Calderdale and Huddersfield NHS hospitals Trust is currently in deficit. It will continue to be in deficit next year, even though it has to make as yet unspecified cuts, and by the end of next financial year it will have no cash reserves and will be totally dependent on the Department of Health for any bail outs it needs.

Monitor – the NHS competition enforcer – explained this situation to the Calderdale and Kirklees Councillors on the Joint Health Scrutiny Committee in March this year.

One reason why the hospital Trust is in deficit is because it was unable to make the required year on year efficiency cuts of 3-4%/year, and continue to protect patient care and safety. So it didn’t make the cuts.

This makes it clear why Clive Peedell called the letter writers “irresponsible” in accepting the Tory government’s new £22bn efficiency cuts programme.

Regardless, the letter signed by Owen Williams and other NHS bosses says that, without the extra £8bn/year plus funding for “transformation” and social care,

“…we will have to make even tougher choices – which we can do if required.”

The letter signed by Owen Williams and other NHS Confederation bosses also says that NHS England’s 5 Year Forward View:

“…may mean reconfiguration of services at pace – which will require support rather than blocking locally for short term political gain.”

This sounds like code for “Let us shut Calderdale A&E and acute services and close more beds, now you’ve won the election.”

Rosemary Hedges, Secretary of Calderdale 38 Degrees NHS Campaign Group, said:

“Once again our local health services are sacrificed for the sake of ideologically driven and unnecessary cuts. The government bailed out the banks – why can’t they bail out our hospitals?”

Rosemary Hedges speaking at Calderdale Royal Hospital Valentine's Day Love In. Photo credit: Charlie Gates

When he visited Halifax to support the Conservative Parliamentary candidate Philip Allott’s General Election campaign, David Cameron promised that Calderdale A&E will stay open.

But the letter from Owen Williams and his colleagues in the NHS Confederation tells the Prime Minister that they want to him to provide:

“The political will and financial certainty [that] will create the space for local leaders to get on with reshaping services.”

Never mind that the proposals to reshape services in Calderdale into “Care Closer to Home” are without any evidence base – as Calderdale Council’s People’s Commission made clear, to the point of calling for a halt in their implementation until and unless evidence could be found that would justify going ahead with them.

Despite these fine words, Calderdale Council has done nothing about stopping this NHS shake up, which it could have done through its Adults Health and Social Care Scrutiny Panel.

On the contrary, Calderdale Council is embedded in the very scheme its People’s Commission condemned as lacking any evidence base to justify it – and NHS England recently fast tracked this Care Closer to Home scheme, by awarding “Vanguard” status to the Calderdale “local health economy”. This consists of Calderdale Clinical Commissioning Group, Calderdale Council, Calderdale and Huddersfield NHS Foundation Trust, Locala, GP Pennine Alliance, SW Yorkshire NHS Foundation Trust (the mental health Trust) and Voluntary Action Calderdale (which represents over 300 health-related social enterprises and charitable organisations).

So now instead of an NHS, we have a health economy, which is to form a New Model of Care that NHS England’s 5 Year Forward View calls a “multi-speciality community provider”.

In this New Model of Care, one “lead provider” will  be awarded a massive contract to provide Care Closer to Home, and this contract will allow secretive subcontracting from the “lead provider” to numerous private companies and charitable organisations.

This New Model of Care offers private health and insurance companies better opportunities to get their hands on NHS cash, than are currently available in the system of competition and tension between purchasers and providers, as set up by the Health and Social Care Act 2012.

So it seems that the NHS bosses, dancing to NHS England’s tune, are happy to cut £22bn of our hospital services in exchange for a bite at the lead provider cherry.

Here’s the letter.

Plain Speaker asked Owen WIlliams if he’d like to comment on the following questions:

  • How can you sign a letter accepting the proposed £22bn efficiency cuts, given that CHFT is suffering a deficit that Monitor predicts will continue this year and next, that will clean out CHFT’s financial reserves by 2016, and that, according to Monitor, has as one of its major causes CHFT’s inability to make yearly efficiency cuts at the same time as protecting patient care and safety?
  • What tougher choices would you make – as the letter says you will if required – if the government doesn’t come up with the extra £8bn/year plus extra funding for service transformation and social care?
  • Now that he’s won the election, are you asking David Cameron to ditch his promise, reported in the Halifax Courier, that Calderdale A&E will stay open?

But he has not replied.

3 thoughts on “Hospital bosses’ “irresponsible” acceptance of £22bn efficiency cuts will harm patient care

  1. The £8bn per year was a promise. Why write a letter straight after the election giving Camaron the option to go back on the promise? Very weak.

  2. You have given a description of the Calderdale ” local health economy”. This is very useful as these phrases are thrown about and we often don’t know what they mean. .
    It becomes apparent ” the local health economy” in Calderdale equals the local acute hospital trust, the local council, the local mental health trust, and Locala and GP Pennine Alliance ( not sure what these two are ) and Voluntary Action Calderdale.
    Are you suggesting that this ” local health economy” would be regarded as the ” lead provider”?
    I agree that the Five year forward view plan is that lead providers should run MCPs ( multispecialty community providers ) and that the MCPs should subcontract out the care to all and sundry including private companies and charities.
    They would be responsible for GP care, mental health care, on call care, physio, outpatients, some formerly regarded hospital procedures, prevention and public health,district nurse care and most important social care ( which is means tested ). They could cover huge populations from 50,000 to 300,000.
    In my view, this aggregating of the local health economy is a means of siphoning off funds from acute care, public health, out of hours and social care into one pot of money ( integration of health and social care budgets) all destined for this lead provider.
    I believe this arrangement is an interim vehicle to tendering the lead provider out to the market. With all these funding streams, the incoming management company would be in a position to make significant profits.
    Anna Athow.

    • Thanks for your comment Anna. To answer your questions, What I understand from the information I’ve been able to glean from the CEO of the Calderdale GPs’ private shareholder company Wainhouse Healthcare Ltd also known as Pennine GP Alliance, and from Calderdale Clinical Commissioning Group (I’m waiting for replies to various Freedom of Information requests), is that the GPs’ Private shareholder company is likely to bid for the lead provider contract, as the Multi-speciality Community Provider. But as their CEO told me, this is in no way decided, although it is likely to be decided soon, one way or another. Locala is a spin out “community interest company” from the former Kirklees Primary Care Trust. Until N. Kirklees & Greater Huddersfield CCGs put the Kirklees Care Closer to Home contact out to tender, Locala was the main community healthcare provider in Kirklees (and still is, since the Care Closer to Home contract award has been suspended, for reasons the CCGs won’t explain but which people are assuming is because the losing bidder is contesting the contract award). Pennine GP Alliance, as I tried to explain in the article, is the other name for Wainhouse Healthcare Ltd and is the GP Federation for 23 out of the 25 Calderdale GP practices.

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