A few weeks ago, a Wigan Council press release announced that the Council had made the Wrightington Wigan & Leigh hospital trust a financial offer that had averted the Trust’s transfer of its support staff into a Wholly Owned Subsidiary.
Amid rejoicing that Wigan hospitals staff were to remain as NHS employees and that the cost-cutting Wholly Owned Subsidiary was not happening, Unison called off the planned strike.
But some feared it might be Out of the Wholly Owned Subsidiary frying pan into the Accountable Care fire.
To find out, I sent Wigan Council a Freedom of Information request.
They have now replied with this paper for August 2nd Cabinet from the Director of Resources (Deputy Chief Executive).
It says that:
The “transformation required to balance the health economy by 2020” means cutting £140m NHS and social care costs – the size of the projected funding shortfall by then.
Rather than stand by hospital staff who were prepared to strike to defend their hospitals from cuts to vital support services, it seems that Wigan Council pulled the rug from under their feet, the better to accelerate other NHS and social care cuts. This has been widely celebrated as a victory for the unions and their hospital staff members. However NHS unions have been playing some odd games recently.
Wigan Council’s reply to my FOI request doesn’t answer two of my questions:
- What cost-cutting service transformations is the hospital Trust to invest this money in?
- What is the evidence that the financial savings are achievable and will not damage the quality and safety of NHS services?
The Deputy Chief Executive’s Report recommends that:
Cabinet delegates to the Leader and Director of Resources the ability to finalise the arrangements with health partners to hand over £2m once the legal and budget framework issues have been resolved.
It says that the Council has “pump primed…development of…new operating models to run…transformed services and staff” with a “one off short term” £2m investment that should be cost neutral, as it should save £2m and the hospital trust will then return this money to the Council.
It doesn’t say what these “alternative operating models” to the WOS are – just that they
“include but are not limited to all options previously deferred in favour of the WOS (which has now been permanently discontinued).”
So I have written back to ask what these previously deferred options are and what additional alternative operating models are being added to that list.
16 words for “cuts”
The Wigan Sustainability and Transformation Plan – aka Healthier Wigan, and referred to in the report to Cabinet as “the Wigan health economy” – has to make £140m NHS and social care spending cuts by 2020 because of government underfunding.
The Deputy Chief Executive’s Report to Cabinet says the Council’s £2m “investment” could help the Trust to
“press ahead on an urgent basis to implement…reforms in order to meet the system efficiencies required to meet the overall system challenge…”
At my count that is 16 words to say “cuts”.
Doing austerity’s job
This vacuous assertion with no evidence for it that efficiency savings can result in more service for less money is being played out all over Greater Manchester (and nationally). So Labour local authorities and councillors are doing austerity’s job through “necessary pragmatism”.
A 2015 Journal of Representative Democracy article by Manchester University health policy academics noted that the Greater Manchester local health economy is faced with a £2 Billion deficit over the five years 2015-2020. This is in addition to the deficit problems faced by local authorities in relation to funding social care. Austerity matters. The article quotes Bob Hudson (a Kent University Centre for Health Studies Professor):
‘there is little political patience for longer term organic process. In its place, we have grandiose plans drawn up at the top table and cascaded down to the frontline with no public or patient involvement. Typically, these are laden with wholly unrealistic efficiency assumptions.’
It makes the key point that:
‘The financial viability of the devolution programme depends upon savings, which it is claimed will be made by integration of health and social care budgets. The evidence underpinning these claims is thin at best, with little evidence that previous attempts to integrate across the health / social care core funding have made substantial financial savings.’ (Boaden et al. 2006; Stokes et al. 2015).
Labour Councillors in Labour-led Councils may justify their position by saying what they are doing is less bad than if the Tories were doing it.
But in Scotland where Labour can mostly only take control by going into coalition (Proportional Representation for local elections) there are people arguing that they should never do so in present circumstances and instead should actively oppose austerity in support of national Labour Policy – but councillors would have to give up their power, prestige and role allowances and it seems they don’t want to do that.
Just look at how Cllr Nick Forbes, leader of Newcastle Council and the main voice for English Labour leaders of Local Authorities, is opposing the prospect of party members electing council leaders.
At the moment, council leaders are chosen by councillors themselves. The proposed changes are included in Labour’s recently concluded Democracy Review, which also includes plans to give MPs less control over who can stand for the national party leadership.
The Labour Party National Executive Council discussed them on 17th July. If they are approved then they will be discussed at Labour’s Annual Conference in Liverpool, which begins on September 23.