Bullsh*t alert as NHS Commissioners meet to announce decision on hospital cuts proposals

This afternoon (Thursday 20 October 2016) from 2-4pm, Bullshit Alert placards at the ready, hundreds of members of the public are attending a meeting at Cedar Court Hotel, Ainley Top to hear the decision by Calderdale and Greater Huddersfield NHS Commissioners about going ahead with their proposals to:

  • close Huddersfield acute and emergency hospital services,
  • replace HRI with a small planned care clinic that will serve all patients from both Greater Huddersfield and Calderdale,
  • send Greater Huddersfield acute and emergency patients – including all children needing inpatient care – to Halifax hospital,
  • transfer a load of hospital services into so-called “care closer to home” and in the process
  • totally redisorganise primary and community care into a “new care model” procured by a new form of contracting, that creates a kind of private/public partnership or PFI for NHS services, along the lines of the American commercial health care system used by United Health. This company is the former employer of NHS England’s boss Simon Steven. The “new care model” for Care Closer to Home introduces and relies on massive use of digital health technology of a type produced and sold by Cerner, the former employer of NHS England’s Director of Commissioning and Operations, Matthew Swindells.

This abominable Right Care Right Time Right Place proposal is part of  Simon Stevens’ Five Year Plan for the NHS to 2020. This is being accelerated by the so-called Sustainability and Transformation Plans that NHS England and the NHS cuts enforcer NHS Improvement have imposed upon 44 so-called “footprints” or regions across England.

West Yorks and Harrogate is one of the footprints and there is a rally tomorrow outside Wakefield CCG offices, 12-1pm, to show outright opposition to the WY & Harrogate STP, which is to be sent to NHS England tomorrow. Please do your best to attend.

At the Meeting at Cedar Court this afternoon Calderdale and Greater Huddersfield NHS Commissioners will consider a report that sums up the CCGs’ responses to the:

  • consultation findings report,
  • 13th September “stakeholder engagement” event on the consultation findings
  • Joint Health Scrutiny Committee recommendations from their meeting on 30th September,
  • newly-commissioned Equality and Health Inequalities Report, prepared by Midlands and Lancashire Commissioning Support Unit which also prepared the lamentable Consultation Findings report that totally glossed over the massive public rejection of the proposals

As everyone expected, the Report to this afternoon’s Governing Bodies’ meeting shows that the Clinical Commissioning Groups have no concern for the public views – 67% of the public who responded to the public consultation survey said the proposals would have a damaging impact on them and 64% rejected them. In addition well over a hundred thousand people petitioned against the proposals.

Equally, the Report shows that the CCGs have brushed aside just about every single one of the Calderdale & Kirklees Joint Health Scrutiny Committee’s 19 recommendations, by saying they will deal with these serious issues in the Full Business Case – if they decide to go ahead with the proposals. They have to add that condition, otherwise they would get done for predetermining the outcome of the consultation, which is unlawful.

It is gutting to find that Joint Health Scrutiny Committee have sold us, the public,  down the river: their Recommendations to the CCGs completely omit what the JHSC Chair Cllr Smaje said at their 30 September meeting they would tell the CCGs, that:

“The JHSC want the CCGs to take the high level of public concerns, expressed in the consultation and petitions, seriously in their deliberations. That high level of concern must be taken into account.”

I haven’t yet read the Equality and Health Inequalities Impact Assessment Report that the Clinical Commissioning Groups commissioned from Midlands & Lancaster Commissioning Support Unit but from the summary in the CCG’s Report to the Governing Bodies’ meeting, it sounds meretricious, particularly the statement that:

“The model proposed could have a significant positive impact on health inequalities for adults, children and young people and those who experience disadvantage by ensuring improved access to more services in the community”.

This would be laughable – if this were a laughing matter. The fact is that there is NO clarity about whether moving hospital services in the community is going to work, for reasons that we are now boringly familiar with – and also given the Clinical Senate’s doubts,  the opposition from Kirklees Local Medical Committee and the lukewarm response from Calderdale Local Medical Committee.

The CCGs’ Report to the Governing Bodies meeting this afternoon also says that the development of the Sustainability and Transformation Plans have been complementary to the changes proposed by this consultation – a statement which seems seriously at odds with what the new Clinical Commissioning Groups’ finance officer told the 13th Oct Calderdale CCG governing body meeting. He said that, as a result of the Sustainability and Transformation Plan “financial reset”:

“The huge pressure the whole system is going though is driving towards difficult decisions about what the budget can buy in the Health and SOcial Care system.
We have to resolve this across the whole system.”

He said that the “huge asks’’ for efficiency cuts have to deliver around A&E and the 18 week referral for cancer treatments and added,

“Where does the balance come between quality and money?”

He asked if the STP allowed the CCG to “meet the statutory asks” or not. This is about the range and standards of health services that the CCGs have a legal requirement to provide.

He added,

“The level of savings at CHFT is unattainable. This is why West Yorkshire  Sustainability and Transformation Plan discussion is vital, we are entering difficult dilemma time.”

This shows the relevance of campaigners’ questions, which we have been asking since at least May,  about whether the Sustainability and  Transformation Plan conditions imposed on our hospitals Trust are compatible with the Right Care Right Time Right Place proposal.

The Equality and Health Inequalities Impact Assessment Report also proposes that the CCGs “mitigate” some of the public’s concerns from the consultation – I guess this is what Calderdale Clinical Commissioning Group Chief Officer Matt Walsh meant when said the CCGs would “flex the details” of the proposals if/when the public rejected them.

The CCGs’ report to the Governing Body meeting says nothing about the fact that 2 year contracts for 2017/18-2018/19 have to be signed on 23 Dec 2016.  In one of the Calderdale & Kirklees Joint Health Scrutiny Committee meetings, Matt Walsh said that the new Care Closer to Home contracts would be signed on 1 April 2017. Even on that time frame,  the CCGs were unable to tell Councillors on the Committee how they would carry out all the extra work needed to change the “aspirational” Care Closer to Home proposals into contracts for specific services. So how will they do this in 2 months rather than 6 months?

The Report is the usual dogs dinner we have come to expect from the NHS Commissioners as they refuse to listen to the public or examine the contradiction in their own proposals, that result from trying to carry out the impossible demands of the two big NHS quangos, which are run by people with close ties to global American health corporations and are doing the work of successive governments with an ideological drive to privatise the NHS to benefit these very corporations.

The most recent example of this corporate cronyism is David Cameron’s departure as a  speech maker for US venture capital company Bain Capital – having allowed, as prime minister, the Dept of Health to sell off the NHS Blood Plasma service to Bain Capital who then sold it on at vast profit to a Chinese company.

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