The future of Calderdale Royal Hospital is a “moveable feast” since Monitor has put it into special measures as a result of its deficit, Craig Whittaker MP said at his open surgery in Mytholmroyd on Saturday 18th July.
Monitor is the organisation charged with enforcing market competition in the NHS. Its boss David Bennett (previously a Senior Partner at McKinsey, the management consultancy company that’s made a killing out of the corporate capture of the NHS under both the New Labour and Coalition governments) recently warned that if NHS Foundation Trusts don’t bring down their deficits, they will lose their freedom to decide their own strategy and the way they run their services.
Craig Whittaker’s remark brings Monitor’s threat close to home for people in Calderdale, who need to know what’s happening to our hospital.
Calderdale Royal Hospital urgent care centre “won’t be an A&E as we know it”
Jane Rendle, Chair of Calderdale 38 Degrees NHS campaign group, reminded the MP that before the election, David Cameron had come to Halifax and said the A&E will not close. She said:
“We have to be able to trust politicians.”
Craig Whittaker MP replied,
“What’s wrong with an urgent care unit? How would closing the A&E (and I’m not saying it is closing) affect people in Calderdale? There will be emergency care at Calderdale Royal Hospital. But it won’t be an A&E as we know it.”
Jane Rendle asked,
“Are you going to go to the Cabinet Office and ask them what they’re going to do to keep the A&E in Halifax?”
The MP said,
“No. David Cameron said there is no intention to close the A&E on the basis of information in the document.”
Which document? Since it was a pre-election document, it will now be out of date as the CCGs are fine tuning their plans for the future of the hospital.
Commission to decide if the NHS should continue to be publicly funded
Jane Rendle asked Craig Whittaker if the Department of Health’s Minister for Productivity, Lord Prior, was expressing government policy when he proposed a “commission of inquiry” into whether the NHS should continue to be publicly funded, or whether it should be funded by private insurance and co-payments.
Lord Prior made the proposal on 9th July after a House of Lords debate, where he said the assumption of a tax-funded NHS ‘has to be questioned’.
Craig Whittaker said this is not government policy and he wasn’t aware of the debate.
MP says Councils didn’t have to cut social care services, causing a knock-on effect on acute services
Another member of the public spoke to the MP about issues with lack of community services and the knock on effect this has on acute services (a countrywide problem). He acknowledged the big holes in mental health services especially for younger people.
But on being told that A&E is overrun because of a lack of Intermediate Care and Reablement Services for people to go to, and that Day Services provision got axed in 2010 when the Coalition Government made cuts, Craig Whittaker replied that Councils could have chosen to cut other services instead.
Cuts to GP funding
Asked by Jane Rendle’s about the size of government cuts to GP funding, Craig Whittaker replied:
“At a Brighouse Surgery, 7 GPs only work part time because they can earn more through the private system because of the contract.”
Since our MP apparently answered the question he wished he’d been asked (about GP contracts), not the question he was actually asked, let’s answer Jane’s question for him.
In 2013, analysis by the Royal College of GPs found that over the past three years, investment in general practice had fallen by £400m in real terms, equivalent to a 7% cut in spending per patient.
Using data from the Health and Social Care Information Centre, the RCGP reported that in 2012-13, £8.5bn was invested in general practice, when everything from spending on pay, IT, tests and drugs was taken into account.
That compared with £8.3bn in 2009-10, which is the equivalent of £8.9bn in 2012-13 prices.
In terms of spending per patient, that represented a fall from £168.40 a year to £156.45. The investment represented 9% of the entire NHS budget, even though GPs had 90% of the contacts with patients.
ByJune 2015, the RCGP was reporting that the share of the NHS budget for general practice had fallen to an all-time low of just 8.4% of the total NHS budget in England.
GPs and their teams are now seeing 370m patients per year – 60m more than five years ago – but as patient demand has risen and patients’ needs have become more complex, funding has fallen.
And 8.4% of the total NHS budget isn’t 8.4% of a growing budget, it’s 8.4% of a shrinking budget.
The NHS budget has effectively flatlined since 2010, with just a 0.1% increase/year. But this has to be set against the £20bn “efficiency savings” that NHS organisations had to return to the treasury between 2011/12-2014/15.
Originally the government’s promise was that efficiency savings would be reinvested in the NHS, but Department of Health accounts for 2012/13 showed that the underspend was returned to the Treasury’s coffers to make up for a shortfall in tax income aka “fiscal challenge”. An NHS underspend of over £1.4bn was similarly handed back to the Treasury in 2011/12. So over those two years, the Department of Health handed over nearly £3bn unspent NHS money to the Treasury.
I haven’t been able to find how much the Treasury clawed back from the NHS efficiency savings in 2013/14, but a Health Service Journal article titled “We have been misled over NHS Funding” reported that another large NHS underspend in would end up in the Treasury in 2014.
In Calderdale, efficiency savings have recently amounted to 4%/year of the NHS budget.
So an NHS funding increase of 0.1% and an efficiency cut of 4% means an effective yearly cut in NHS funding in Calderdale of 3.9%/year. And that’s before you take account of the £billions/year of NHS funding that’s diverted from patient care into the costs of privatisation and marketisation. And then the £Billions more diverted into Council social care services through the Better Care Fund.