Unhealthy salaries - NHS has money to "spray on its directors"

From Private Eye 19th June 2017

Leak shows 'devastating' impact of planned NHS cuts in London - "Capped Expenditure Process" in N Central London

https://www.theguardian.com/society/2017/jun/20/leak-shows-devastating-impact-of-planned-nhs-cuts-in-london    published 20th June 2017.

Internal document reveals cost-saving options to plug £183m gap in funding for 10 hospital trusts in capital.

Patients will be denied treatment, waiting times for operations will lengthen and A&E and maternity units may be shut under secret NHS plans to impose unprecedented cuts to health spending in London.

According to an internal NHS document seen by the Guardian, doctors in five London boroughs will have to spend less on drugs, fewer patients will be referred to hospital and support for people with severe health needs will be cut as part of the plan.

It outlines the “difficult choices” NHS bosses nationally are forcing the 10 hospital trusts in north-central London to make in the next few months in order to plug a £183.1m gap in their finances.

The 31-page document was circulated among dozens of top NHS officials in the area on 25 May. It outlines how the “capped expenditure process” will hit the provision of NHS care to the 1.44 million people who live in the boroughs of Camden, Islington, Haringey, Barnet and Enfield.

It admits that pushing through such cutbacks will be unpopular and hard to explain – and result in poorer care. “We recognise that these choices may be difficult for a number of reasons [because they include] … options that impact on quality of care [and] options that would be difficult to implement,” it says.

The hospitals that have been told to implement draconian cost-cutting measures include some of the NHS’s best-known names, such as the Royal Free, University College London and Great Ormond Street children’s hospital.

North Central London (NCL) is one of 14 areas of England where NHS England and NHS Improvement, the service’s twin regulators, are forcing hospital trusts to make far-reaching cuts during 2017-18 as part of the “capped expenditure process”. They have told local NHS leaders to “think the unthinkable” in their quest for savings.

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Most of central London hospital to be sold off, plans reveal - The Guardian

Charing Cross hospital to be cut to 13% of current size and services diverted to facilities around the city, documents show.


Published on Friday 16th June in The Guardian.

"Almost all of a central London hospital is to be sold and its services diverted to already stretched facilities around the capital under plans for NHS modernisation seen by the Guardian.

Charing Cross hospital, a flagship NHS facility in the heart of London, is to be cut to just 13% of its current size under proposals contained in sustainability and transformation plans published last year in 44 areas across England.

Many of the officially published plans lacked precise detail about how local services would change, but internal supporting documents seen by the Guardian reveal the scale of the closures at the London site.

The proposals claim much of the care currently offered at Charing Cross can be transferred to “community settings” such as local GP services, but health campaigners and clinicians say the transformation could endanger patients.

The documents include a map detailing how 13% of the current hospital site will remain, with the rest of its prime real estate in central London sold off. The plan is to introduce the changes after 2021.

The NHS chief executive, Simon Stevens, is thought to be taking a particularly keen interest in what happens at Charing Cross. The site has become a battleground over planned closures of local services, and if the radical changes are adopted here it may be easier to introduce them across the rest of England.

NHS chiefs have stated as recently as March that “there have never been any plans to close Charing Cross hospital”, and in March 2015 the then prime minister, David Cameron, said it was “scaremongering” to suggest that the Charing Cross A&E departmentwas earmarked for closure. The health secretary, Jeremy Hunt, echoed the claims.

However, in the internal NHS documents the apparent downgrading of Charing Cross is outlined in great detail.

The plan is to axe 10 major services at Charing Cross – 24/7 A&E, emergency surgery, intensive care and a range of complex emergency and non-emergency medical and surgical treatments. The remaining services would be a series of outpatient and GP clinics, X-ray and CT scans, a pharmacy and an urgent care centre for “minor injuries and illnesses”. Around 300 acute beds will be lost.

The internal documents state: “The significant impact of reconfiguration on inpatient activity will be the movement of activity from Charing Cross and Ealing.”

The plans have sparked a row between the borough where Charing Cross is based – Labour-controlled Hammersmith & Fulham council - and the NHS North West London Collaborative of Clinical Commissioning Groups, which is driving the changes.

Stephen Cowan, the leader of the council, has accused the NHS chiefs of deliberately misleading the public about the Charing Cross plans.

“It’s like demolishing someone’s house only to tell them they have in fact not lost their house – because they’ll be given a new garden shed which will be called their ‘local house’,” said Cowan.

He said NHS chiefs had rebranded the urgent care centre for minor injuries and would be run by GPs and nurse practitioners as a local A&E.

“That still constitutes the demolition and closure of Charing Cross hospital in its current form. No one would see what is left as a hospital in any generally accepted definition of the word,” Cowan added. “A ‘local hospital’ is a clinic. A class 3 A&E is an urgent care clinic.”

A spokeswoman for North West London Collaboration of Clinical Commissioning Groups said: “We are still committed to taking forward changes as agreed by the secretary of state in 2013. We have been clear that we will have local services in place to meet demand and deliver the necessary services for patients before we make any changes to Charing Cross.

“Our current focus is on delivering those new and improved services for local people. We have been clear that no changes will be made before 2021 and that for Charing Cross we will bring forward a strategic outline case in the future which sets out the capital requirement for making these changes and that remains our intention.

“As we look at changes to Charing Cross hospital we will of course continue to work closely with the council and value their important input into these discussions.”

NHS officials have accused Hammersmith & Fulham council of breaching the code of recommended practice on local authority publicity by circulating flyers to residents in March of this year warning of the closure of Charing Cross as a major hospital.

The council delayed replying due to election purdah but Cowan has recently drafted a response to NHS chiefs accusing them of “playing fast and loose with the English language” and demonstrating “a contempt for the public who you evidently hope are taken in by such misrepresentation”.

In the letter, Cowan adds that the published plans for the future of the hospital have avoided mentioning much of the detail contained in the confidential plans.

Charing Cross is thought to be one of five London hospitals that a recent government-commissioned review – by a former University College London hospital chief executive, Sir Robert Naylor – identified as each being worth more than £1bn if sold.

The NHS in England is gearing up to start selling off billions of pounds worth of land and property in order to free up cash to tackle what Naylor estimated to be a £10bn backlog of repairs to sometimes crumbling old buildings.

The Health Service Journal disclosed last week that the Department of Health was preparing to create six regional public/private partnerships covering all of England that would oversee such sales. The plan, codenamed Project Phoenix, would see the proceeds from asset sales being shared between NHS organisations and private firms. Under the plan, London and the south-east would comprise one giant, and very valuable, area."

[my bold and underlining]

This is it. This is the "fire sale" of all NHS assets which the Naylor report of March 2017 planned. Public Private Partnerships offer lucrative deals for one side only, the private sector. The NHS will be crippled with £6 billions of debt which it has no means of repaying.

It doesn't have to be this way. As any child knows interest rates are at historic lows. The Government could borrow at 0.5% interest or less. There is NO commercial reason for "mortgaging" OUR NHS assets at astronomically high rates of interest. This Government is unable to say out loud ANY reason for this deal. The real reason is, of course, that they want to control and starve the NHS of funding, all the better to allow the private sector to "eat it"!  It is about a neo-liberal ideological choice.

Guardian Hospitals enquiry: "Is an NHS community hospital near you being closed or downgraded?"

In "The Guardian"'s Society section there is a questionnaire asking about the UK's experience of "downgraded" or "threatened" hospitals: https://www.theguardian.com/society/2017/jun/13/is-a-community-hospital-near-you-being-closed-or-downgraded?CMP=share_btn_tw

This is a very worthwhile exercise, because the more responses they receive the better the issue can be INDEPENDENTLY assessed and analysed. I urge anyone who finds this page to complete the short questionnaire.

Thank you!