Look back in anger: Monitor and EY put Hospital PFI investors above people of Calderdale and Kirklees

Just a reminder, in case one is needed, about how the government, its quango Monitor (now renamed NHS Improvement) and the management consultancy company EY have worked hand in glove to put PFI investors’ interests above the healthcare needs of the people of Calderdale and Huddersfield.

Here’s how the story has unfolded over the last 4 years.

In 2014, Calderdale and Huddersfield hospitals Trust’s finances fell into “deficit”, as a result of impossible underfunding combined with a £20m+ transfer over 2 years of Calderdale and Huddersfield NHS Foundation Trust funding to Calderdale Council to prop up its cash-starved adult social care services, via the Better Care Fund.

This fund was introduced in 2014 to allow local authorities and NHS clinical commissioning groups to pool budgets and jointly commission social care services that would take pressure off hospitals. But it did not bring any new money. Instead it required Clinical Commissioning Groups to redeploy money from supposedly ringfenced NHS funding. NHS England 2013 Guidance said this meant:
‘hospital emergency activity will have to reduce by 15%’

This is what happened next.

1.NHS privatisation quango tells #Calderdale and #Huddersfield hospitals trust to cut services fast

Posted on November 14, 2014
Monitor is to investigate the reasons why our Hospitals Trust is facing a deficit at the end of this financial year.

Monitor is the quango set up under the 2012 Health & Social Care Act, in order to open up the NHS to EU competition law as a way of speeding up the pace of NHS privatisation.

Moves by Paul Chandler, Regional Director at Monitor, to blame the Trust’s management for the deficit do not distract from the self-evident fact that the looming deficit is the result of central government tightening the funding screws on the NHS.

This year, the government has told the Trust to make “efficiency savings” – ie cuts – of £20m. After years of “efficiency savings”, there are no longer ways for the Trust to safely make such a big cut to its spending.

2.  In the Outline Business Case,  CHFT’s preference for how to centralise services was to make CRH into a small planned care clinic plus a care home/hospice. They wanted to make HRI the acute/A&E centre.

Calderdale Royal Hospital’s future as small planned care clinic plus Care Home and Hospice

Posted on November 28, 2014

The hospitals Trust has finally made public their Outline Business Case (OBC) for the shake up of hospital and community NHS services in Calderdale and Greater Huddersfield.
The OBC comes down on the side of making Calderdale Royal Hospital the small planned care hospital, carrying out planned treatments like hip or knee operations, with only 85 of its current 350 beds in use and no A&E, just a Minor Injuries Unit that would see around 22,500 patients a year.

24/7 acute and emergency care would be at Huddersfield Royal Infirmary. This would include trauma, major surgery, crticial care, acute & specialist medicine, inpatient paediatric services and complex maternity services.

3. Councillors tried to scrutinise Monitor but weren’t a match for them.
Hospital cuts and review of whole local NHS as “perfect storm” of increasing financial pressures batters our hospitals
Posted on April 7, 2015

Staff from Monitor (the NHS competition enforcer) were at the Calderdale and Kirklees Joint Health Scrutiny Committee (JHSC) meeting on 25 March to explain what Monitor is doing about our Hospitals Trust deficit.

4. Both Clinical Commissioning Groups put their plans for consultation on hold
Monitor has hospital in stranglehold – hospital cuts and changes consultation on hold
Posted on September 24, 2015

As expected, both Calderdale and Greater Huddersfield NHS commissioners today agreed to postpone the public consultation on proposed hospital cuts and changes. The consultation had been scheduled to start this month.

One burning issue for the public is what NHS bosses want to do to our A&Es. A slide presented at the meeting showed we could end up without a full A&E at either hospital. The slide said that one emergency centre or specialist emergency centre is planned – but draft specifications from NHS England say that only specialist emergency centres provide full A&E care.

The delay to the public consultation is because the Clinical Commissioning Groups don’t know if the hospitals Trust will be financially viable in five years time and are waiting for it to produce a Five Year Financial Plan.

5.  Monitor/CHFT brought in EY

Covering #Calderdale Royal Hospital PFI contract costs could force shrinkage of #Huddersfield Royal Infirmary
Posted on October 23, 2015

At the 21 October Joint Health Scrutiny Committee meeting, Councillors tried to find out what the NHS competition enforcer, Monitor, actually meant by stating that the hospitals Trust needs to:

“maximise the value of the Calderdale Royal Hospital (CRH) PFI contract”.

But they didn’t have the skills or knowledge to frame appropriate questions.

6. Ernst & Young calling the shots over Right Care Right Place Right Time scheme
Posted on November 16, 2015

The clinical model for the proposed Right Care Right Place Right Time scheme, that NHS commissioners and the Calderdale and Huddersfield hospitals have finally agreed after arguing about for two years, could be thrown up in the air yet again by a cost-cutting 5 year hospitals financial plan that is being drawn up by Ernst and Young (EY), at a cost of £500K to the deficit-ridden hospitals Trust.

Our hospitals may be broke, but the global management consultancy company EY had a global income of $US28.7bn in the financial year ending 30 June 2015. This is its fastest growth since 2008, an 11.6% increase over 2014. Obviously clearing up the mess from the 2008 bankers crash of the world economy is good business for EY and its ilk.

7. Calderdale and Kirklees 999 Call for the NHS then organised street protests to alert the public.

Halifax people tell Monitor, sweep profiteering Ernst and Young out of our hospitals
Posted on November 30, 2015

On Saturday 28th November, hundreds of Halifax shoppers were shocked to discover that global accountancy company Ernst and Young (EY) is calling the shots over the future of Calderdale Royal Hospital and Huddersfield Royal Infirmary – at a budgeted cost to the hospitals Trust of £1m for 3 months work.

And Sweep Calderdale & Huddersfield Hospitals clean of Ernst & Young

8. Once the EY 5 year Plan for the hospitals Trust had been produced, lo and behold the Trust’s Pre Consultation Business Case flipped the preference for making the Private Finance Initiative hospital the planned care clinic + hospice + care home and instead made it the acute/A&E hospital,  and proposed knocking down HRI and replacing it with a small planned care clinic and urgent care centre (excluding 0-5year olds)

Independent clinicians “in the dark” about standard of care if these cuts and changes happen

Posted January 27, 2016

Lack of clarity in Calderdale and Greater Huddersfield NHS Commissioners’ Pre Consultation Business Case proposals for cutting and changing hospital services has left Clinical Senate doctors in the dark about the standard of care that would be available if these changes were to go ahead.
NHS Commissioners asked the Clinical Senate to review their proposals, specifically to
“answer questions regarding the ability of this model to deliver the standards proposed.”

8. We then handed in a protest at Monitor’s London office

Sweep out NHS privatisers, Save our A&Es protest is first – but not last – at Monitor office

Posted on January 18, 2016

Friday 15 Jan was the day that Calderdale and Huddersfield NHS market bureaucrats finally published their pre-consultation business plan for the hospital cuts that have been hanging over us all in Calderdale and Huddersfield for 2 years now.

It was also the day that members of Calderdale and Kirklees 999 Call for the NHS handed in 49 letters of protest to Monitor, the NHS market competition enforcer. (Kind of like Ofgem for the NHS.)

The surprised security guard said it is the first protest there’s been at the Monitor offices at 133-135 Waterloo Road, SE1. It won’t be the last. (He also said photographs at the Monitor offices are not allowed, but by then it was too late.)

9. We have continued to protest. Most recently by sending a report to the Independent Reconfiguration Panel

CK 999 asks Independent Reconfiguration Panel to stop #Calderdale & #Huddersfield NHS cuts

Posted September 2nd, 2017

Calderdale and Kirklees 999 Call for the NHS has sent the Independent Reconfiguration Panel a letter and report on Calderdale & Huddersfield hospitals Trust’s Full Business Case, asking them to carry out a full investigation of the proposed Calderdale and Greater Huddersfield NHS reconfiguration, that the Calderdale and Kirklees Joint Health Scrutiny Committee has referred to them for review.

Having thoroughly studied the proposals as they have been developed over the past three years, and taken part in the consultation and the post-consultation scrutiny process, we are of the firm view that the proposed reconfiguration will damage the area’s NHS, will not meet the population’s health needs and has not been properly consulted on.

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