Issue: 46
March 2017
This occasional newsletter is researched, written and edited by a group of concerned residents in Ealing, West London who want to preserve our NHS. We view the wholesale engagement of private, for-profit healthcare service suppliers as unnecessary, profligate and dangerous. Process improvement is what is needed in our NHS – not revolution.
400 Turn Up to ‘Save Our NHS’ Public Meeting at Ealing Town Hall: NHS Bosses Refuse to Participate
It was standing room only at the London Borough of Ealing’s (LBE) ‘Save Our NHS’ public meeting on 15th February 2017. NHS bosses were invited to attend the meeting – but declined LBE’s offer. As well as politicians, the platform speakers were James Guest, Chair of Healthwatch Ealing and Eve Turner, Secretary of Ealing Save Our NHS. James highlighted that in total 865 hospital beds are to be removed across north west London. Eve lit up the evening with her passion and commitment to continue to confront the lies NHS bosses have fed us all and to fight against the planned, massive cuts in finance, beds and staff.
What was revealed to the audience were details of planned cost savings, staff cuts, reduction in hospital beds, the downgrading of Ealing and Charing Cross Hospitals, and closure of A&E units. Facts and anecdotal evidence emerged about the current and future impact of savage cuts to social services. One patient had been discharged from hospital and sent for convalescence at Clayponds Hospital. Subsequent discharge from there was to the local Premier Inn Hotel – for four weeks!
Major issues raised at the meeting included delays in seeing GPs, waiting times at A&E, delayed elective surgery and inadequate mental health and social services. All residents were urged to quiz their GPs about future Primary Care arrangements. There was a general consensus that Ealing GPs had been consistently silent about any possibly negative aspects of planned cuts and changes.
It was pointed out that the latest healthcare and social care proposals – the North West London Sustainability and Transformation Plan (STP) – followed the approach of the failing 2012 NHS NW London ‘Shaping a Healthier Future’ (SaHF) plan. (One major difference however between SaHF and STP is that STP attempts to cut costs and improve healthcare and social care services. SaHF only tries to improve and cut costs for healthcare). The Leaders of Ealing and Hammersmith & Fulham Councils confirmed that they had refused to sign up to the STP.
We heard horror stories from NHS staff about days when no carers and no A&E beds were available. Hillingdon Hospital A&E performance continues to be the worst in England. Councillor Aysha Raza pointed out that when Ealing hospital is downgraded many more patients and their loved ones will have to travel to Northwick Park Hospital in Harrow. She has researched the difficulties for Southall residents travelling to Northwick Park. It’s three buses and an overall journey time of 1 hour and 45 minutes!! She was not alone in criticising Dr Mohini Parmar, who seemingly runs Ealing Clinical Commissioning Group, SaHF and the STP. Aysha has noticed that Dr Parmar’s favourite technique when confronted in public with difficult questions or requests for evidence is to announce that ‘a piece of work is underway to provide/answer this’. However such work never seems to emerge as a report in the public domain.
North West London Councillors Quiz Care Planners
On 20 February 2017 I attended, as an observer, a meeting of the North West London Joint Health Overview & Scrutiny Committee. In theory two Councillors from each of the eight Local Authorities attend these six-monthly meetings. At any one time there were no more than ten Councillors attending. Claire Parker led the small team of NHS NW London bosses. On the agenda were big topics – the £513 million capital request for NHS SaHF building work in outer NW London, and the NW London STP.
Quite frankly some of the Councillors questions and observations were banal and irrelevant. However a few of them were brilliant. Councillor John Coombs from Richmond outlined that in Germany STP proposals had been implemented over the last two years. They were failing in spite of the fact that Germany has more doctors, nurses and hospital beds per 1,000 population than England.. Here in England the NHS has cut hospital beds for years and plans to cut many more. One third of all our doctors are approaching retiring age. We have fewer trainee nurses. The Government is cutting back on immigration. Pharmacies (which could take some pressure off GPs) are being closed down. And we plan to reduce spending as a percentage of GDP on healthcare and social care over the next five years. Just how can these SaHF/STP proposals succeed? A spontaneous round of applause broke out from the spectators’ gallery. Ms Parker was clearly rattled by this and blurted out that there are problems but there’s plenty of waste in the care system and massive savings can be achieved by eliminating waste. I’d be surprised if anyone in the room found this a credible response.
The SaHF cash request, which might eventually find its way to H.M. Treasury, breaks down into £69 million for GP surgeries’ enhancements, £141 million for Out Of Hospital /Hubs and £303 million for Acute sites. The NHS expects to receive £9 million from selling off land on the Ealing Hospital site and £7 million from other land sales. No clues are provided as to where a new healthcare facility might be located on the Ealing Hospital site or when and where demolition will take place. Best estimate for when a new healthcare facility will open on the site is November 2022. The NHS bosses are keen to call the new facility a ‘Local Hospital’. What it will actually be is a Day Care Centre with some ‘Frail elderly beds’.
Painful statements which NHS bosses uttered include:
+ ‘ If we don’t get the £500 million – there is no plan B’
+ ‘We have more work to do on clinical models’
(Isn’t 4 years long enough to have sorted this out?)
+ ‘The ‘Evening Standard’ article about job cuts was wrong. We won’t be reducing staff numbers. The information came from draft documents’
(The fact is that the 7,753 jobs cuts by 2020/21 was contained in the formal response by the NHS to a Freedom Of Information request)
+ ‘ The 2012 SaHF plans did not include any provision for illness prevention, mental health or social care services’
+ ‘We are not closing beds to save money’
(If this is true – why are they doing it?)
+ ‘The NHS NW London estate (i.e. its properties) is in worse condition than anywhere else in England’
(How can this have happened? Surely CCGs, Trusts, NHS England and now defunct PCTs should hang their heads in shame)
At the end of the meeting the Chair Councillor Mel Collins asked Ms Parker if the SaHF/STP proposals were either about residents’ health or cutting costs. She replied ‘residents’ health’. Just how refreshing would it have been if she had answered truthfully along these lines ‘They are about cutting costs. We have to reduce our annual spend by £1.4 billion by 2021. However we will do everything we can to provide the best care we can from 2021 with just 60% of the money we are currently spending each year’.
NHS NW London Clinical Commissioning Groups (CCGs) Argue With Themselves About Staff Cuts
Recently an activist with Brent Patient Voice submitted a Freedom of Information request to NHS bosses about future care staff STP cuts across NHS NW London. The detailed reply quoted 7,753 job losses by 2020/2021. The ‘Standard’ newspaper picked up and ran the story.
Incredibly the self styled ‘Combined CCGs of NW London’ responded to these reported cuts as follows:
‘We have no plans to reduce the overall number of health and care staff across NW London – in fact the total number is likely to increase to reflect increasing demand.’
Is this a case of the left hand not knowing what the right hand is doing? Or is someone simply lying?
New Health Centre on Ealing Hospital Site by November 2022?
Under the auspices of the failing 2012 ‘Shaping a Healthier Future’ (SaHF) project the NWL CCG supergroup now say that what they call ‘Ealing Local Hospital’ will be built on the Ealing Hospital site by November 2022. As SaHF has missed all previous deadlines we should take this date with a pinch of salt. More salt is needed to believe that H.M. Treasury will sign off ‘in principle’ £500 million of capital spending needed for this (and other building projects) by February 2018. However the so called ‘Full Business Case’ will not be created and submitted before September 2018 – with Treasury re-blessing expected by April 2019.
As for the new facility, it won’t contain a traditional A&E unit. No blue light ambulances will visit. There will be no Intensive Care beds or consultants, no Maternity unit, no Paediatrics unit. It will primarily feature lots of GPs, diagnostics, outpatients, an Urgent Care Centre and ‘extended services for frail elderly people’- whatever that might mean. Apparently there will be 50 beds for the frail elderly.
There are no details on where this new, small facility will be built on the site or when the Major Hospital building that is Ealing Hospital will be demolished.
West London Mental Health Trust (WLMHT) Receives Poor CQC Ratings in Two Consecutive Years
The Care Quality Commission (CQC) carried out a full inspection of WLMHT in November 2016. Its report was published on 9 February 2017. The report does not make pleasant reading. CQC rated 9 of the Trust’s 11 services as ‘Requires Improvement’. Staff recruitment and retention, patients’ physical health needs, acute ward capacity, poor inpatient environments, and governance processes were cited as areas needing improvement. CQC did find some improvements since its inspection and critical report in 2015. These were in staff morale, better incident reporting, working with partners, creating a single point of access, enhanced assessment and treatment teams and a new Primary Care mental health service.
It’s not as though all London mental health Trusts are performing as badly as WLMHT. In December 2016, CQC rated South West London and St George’s Mental Health NHS Trust as ‘Good’ in 8 out of 10 services, and Barnet, Enfield and Haringey Mental Health Trust as ‘Good’ in 5 out of 10 services.
The NHS Better Care Fund – Yet Another Expensive, Cost-Cutting Failure
The NHS Better Care Fund (BCF) was first announced in June 2013. £5.3 billion was to be spent on transforming local health and social care services by pooling resources. Major goals were reducing the number of hospital admissions and making annual cost savings of £1 billion. In November 2014, the National Audit Office (NAO) branded the BCF plan a ‘shambles’. It could find no evidence as to how these cost savings were going to be achieved. The BCF went ‘live’ on 1 April 2015.
In November 2015 the Government froze the BCF at £3.8 billion.
So what has BCF achieved? According to the NAO very, very little:
+ The BCF target of reduced hospital admissions was 106,000. In fact over the BCF period hospital admissions have risen by 87,000!
+ The BCF has not achieved any cost savings. In fact the BCF has cost an additional £311 million!
+ Better co-operation between NHS healthcare bodies and Local Authorities social care organisations has been observed
+ There have been no announcements or measurements of ‘better care’.
BCF is another clear example of gross incompetence by Government, the Department of Health and NHS England. One hopes whoever was responsible for designing, goal setting and managing BCF will apologise, resign or be sacked. Norman Lamb MP when serving as a Government minister helped draw up these plans. He is quite obviously one of the culprits.
